Provider Demographics
NPI:1538120183
Name:CAIRE, MICHAEL JORDAN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JORDAN
Last Name:CAIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 MERCEDES DRIVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201
Mailing Address - Country:US
Mailing Address - Phone:318-537-9320
Mailing Address - Fax:318-537-9323
Practice Address - Street 1:3130 MERCEDES DRIVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-537-9320
Practice Address - Fax:318-537-9323
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD012257207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1539121Medicaid
LA5K078OtherMEDICARE ID
LA5K078OtherMEDICARE ID