Healthcare Provider Details

I. General information

NPI: 1215986112
Provider Name (Legal Business Name): NOLIA M MCGEE DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 WRIGHT AVE
CROWLEY LA
70526-2220
US

IV. Provider business mailing address

PO BOX 159
OPELOUSAS LA
70571-0159
US

V. Phone/Fax

Practice location:
  • Phone: 337-783-8387
  • Fax: 337-783-8389
Mailing address:
  • Phone: 337-942-7567
  • Fax: 337-948-4993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPD128R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: