Provider Demographics
NPI:1144842741
Name:MICHELLE EAGAN, LLC
Entity type:Organization
Organization Name:MICHELLE EAGAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:EAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-459-1688
Mailing Address - Street 1:5500 PRYTANIA ST # 412
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-4221
Mailing Address - Country:US
Mailing Address - Phone:504-459-1888
Mailing Address - Fax:504-459-1788
Practice Address - Street 1:15715 PROFESSIONAL PLZ
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1452
Practice Address - Country:US
Practice Address - Phone:504-459-1888
Practice Address - Fax:504-459-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty