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NPI Code Detail

MEDICARE: DR. MICHAEL D ROKAW MD

MEDICARE: DR. MICHAEL D ROKAW MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician13152RLA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4390006483OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1721404303ROTHEROCHSNER
2A009OTHERCHAMPUS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154317469
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL D ROKAW MD
Provider Business Mailing Address
First Line : 1800 BUCKNER ST
Second Line : STE C120
City : SHREVEPORT
State : LA
Zip : 71101-4440
Country : US
Telephone Number : 318-227-8899
Fax Number : 318-222-0407
Provider Business Practice Location Address
First Line : 1800 BUCKNER ST
Second Line : STE C120
City : SHREVEPORT
State : LA
Zip : 71101-4440
Country : US
Telephone Number : 318-227-8899
Fax Number : 318-222-0407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2005
Last Update Date : 07/01/2010

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Directions to “ DR. MICHAEL D ROKAW MD” Practice Location

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