MEDICARE: MISS KIMBERLY JANE DAO M.D.

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
1	207R00000X	Internal Medicine Physician	MD207.217	LA

General Provider Information

NPI Number	:	1346549524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KIMBERLY JANE DAO M.D.

Provider Business Mailing Address
First Line	:	4657A ALCEE FORTIER BLVD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70129
Country	:	US
Telephone Number	:	504-254-4011
Fax Number	:

Provider Business Practice Location Address
First Line	:	4657 ALCEE FORTIER BLVD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70129-2140
Country	:	US
Telephone Number	:	504-606-2819
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2011
Last Update Date	:	01/15/2015

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