MEDICARE: MICHAEL ASHLEY LEROY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZB0001X	Blood Banking & Transfusion Medicine Physician	MD.205897	LA
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD.205897	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336373422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ASHLEY LEROY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3780
Second Line	:
City	:	TUPELO
State	:	MS
Zip	:	38803-3780
Country	:	US
Telephone Number	:	318-841-9526
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 MEDICAL CENTER BLVD
Second Line	:
City	:	MARRERO
State	:	LA
Zip	:	70072-3147
Country	:	US
Telephone Number	:	504-349-1387
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2009
Last Update Date	:	01/22/2018

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