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General NPI Number Information
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NPI Number | 1144842741
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Entity Type | Organization
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Legal Business Name | MICHELLE EAGAN, LLC
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 06/22/2020
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Provider Practice Location Address
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Address Line | 15715 PROFESSIONAL PLZ
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City | HAMMOND
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State | LA
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Zip | 70403-1452
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Country | US
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Telephone | 504-459-1888
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Fax | 504-459-1788
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Provider Business Mailing Address
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Address Line | 5500 PRYTANIA ST # 412
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City | NEW ORLEANS
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State | LA
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Zip | 70115-4221
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Country | US
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Telephone | 504-459-1888
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Fax | 504-459-1788
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHELLE EAGAN
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Credential | MD
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Telephone | 504-459-1688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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