1871344853 NPI number — MEGHAN DIANE RAYFORD-JENKINS MD

Table of content: MEGHAN DIANE RAYFORD-JENKINS MD (NPI 1871344853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871344853 NPI number — MEGHAN DIANE RAYFORD-JENKINS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAYFORD-JENKINS
Provider First Name:
MEGHAN
Provider Middle Name:
DIANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871344853
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1430 TULANE AVE # 8050
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70112-2632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-988-7809
Provider Business Mailing Address Fax Number:
504-988-3971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1430 TULANE AVE # 8050
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70112-2632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-988-7809
Provider Business Practice Location Address Fax Number:
504-988-3971
Provider Enumeration Date:
03/28/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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