Healthcare Provider Details

I. General information

NPI: 1659812840
Provider Name (Legal Business Name): FRANCISCKA MACIEISKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 JACKSON ST
MONROE LA
71201-7407
US

IV. Provider business mailing address

1584 COUNTY ROAD 322
DE BERRY TX
75639-2682
US

V. Phone/Fax

Practice location:
  • Phone: 318-966-4000
  • Fax:
Mailing address:
  • Phone: 504-232-2935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number324481
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: