Healthcare Provider Details

I. General information

NPI: 1538120183
Provider Name (Legal Business Name): MICHAEL JORDAN CAIRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 01/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 MERCEDES DRIVE
MONROE LA
71201
US

IV. Provider business mailing address

3130 MERCEDES DRIVE
MONROE LA
71201
US

V. Phone/Fax

Practice location:
  • Phone: 318-537-9320
  • Fax: 318-537-9323
Mailing address:
  • Phone: 318-537-9320
  • Fax: 318-537-9323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD012257
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: