=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699869800
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHEL E. HEARD, M.D. APMC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 04/15/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 113 SAINT THOMAS ST SUITE B
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70506-4575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-234-0898
-----------------------------------------------------
Fax | 337-235-3081
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 113 SAINT THOMAS ST SUITE B
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70506-4575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-234-0898
-----------------------------------------------------
Fax | 337-235-3081
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/PHYSICIAN
-----------------------------------------------------
Name | MICHEL EDWARD HEARD
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 337-234-0898
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 013797
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------