MEDICARE: DRS COOGAN, DRUMM AND MELTON

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	208000000X	Pediatrics Physician	411817	LA

General Provider Information

NPI Number	:	1831238336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRS COOGAN, DRUMM AND MELTON

Provider Business Mailing Address
First Line	:	541 SHADOWS LN
Second Line	:	SUITE C
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-6531
Country	:	US
Telephone Number	:	225-925-2446
Fax Number	:	225-926-8074

Provider Business Practice Location Address
First Line	:	541 SHADOWS LN
Second Line	:	SUITE C
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-6531
Country	:	US
Telephone Number	:	225-925-2446
Fax Number	:	225-926-8074

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SHANNON SAIN
Credential	:
Telephone Number	:	225-925-2446

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	08/22/2020

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