MEDICARE: DR. ANNA GRAY MCLENDON 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	207Q00000X	Family Medicine Physician	MD8337R	LA

General Provider Information

NPI Number	:	1952673220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA GRAY MCLENDON M.D.

Provider Business Mailing Address
First Line	:	828 ROYAL ST
Second Line	:	# 338
City	:	NEW ORLEANS
State	:	LA
Zip	:	70116-3115
Country	:	US
Telephone Number	:	504-261-3847
Fax Number	:

Provider Business Practice Location Address
First Line	:	616 ROYAL ST
Second Line	:	# 10
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-2116
Country	:	US
Telephone Number	:	504-261-3847
Fax Number	:

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

Provider Enumeration Date	:	02/02/2012
Last Update Date	:	07/27/2015

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