MEDICARE: MICHEL E. HEARD, M.D. (A MEDICAL CORPORATION)

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	332900000X	Non-Pharmacy Dispensing Site	BH2497293	LA

General Provider Information

NPI Number	:	1760682272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHEL E. HEARD, M.D. (A MEDICAL CORPORATION)

Provider Business Mailing Address
First Line	:	3607 OLD CONEJO RD
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91320-2123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	113 SAINT THOMAS ST
Second Line	:	SUITE A
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-4575
Country	:	US
Telephone Number	:	337-234-0898
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. MICHEL E HEARD
Credential	:
Telephone Number	:	337-234-0898

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	06/16/2008

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