Healthcare Provider Details

I. General information

NPI: 1235766395
Provider Name (Legal Business Name): MCCAYN MCDANIEL FAMILIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71211 HIGHWAY 21
COVINGTON LA
70433-7173
US

IV. Provider business mailing address

71211 HIGHWAY 21
COVINGTON LA
70433-7173
US

V. Phone/Fax

Practice location:
  • Phone: 985-893-9922
  • Fax:
Mailing address:
  • Phone: 985-893-9922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number353798
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: