Healthcare Provider Details

I. General information

NPI: 1851373872
Provider Name (Legal Business Name): GREGORY MICHAEL SAVOY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 CAJUN DR STE B
MAMOU LA
70554-2400
US

IV. Provider business mailing address

1508 CAJUN DR STE B
MAMOU LA
70554-2400
US

V. Phone/Fax

Practice location:
  • Phone: 337-468-5309
  • Fax: 337-468-3786
Mailing address:
  • Phone: 337-468-5309
  • Fax: 337-468-3786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number010993
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: