Healthcare Provider Details

I. General information

NPI: 1124714860
Provider Name (Legal Business Name): JAMES MICHAUD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 COURT ST STE A
EVANSVILLE IN
47708-1340
US

IV. Provider business mailing address

516 COURT ST STE A
EVANSVILLE IN
47708-1340
US

V. Phone/Fax

Practice location:
  • Phone: 812-485-2121
  • Fax: 812-485-2151
Mailing address:
  • Phone: 812-485-2121
  • Fax: 812-485-2151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02008953A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: