Basic Information
| Provider Information | |||||||||
| NPI: | 1457592420 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAIGLE | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 54287 | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701544287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3377061605 | ||||||||
| FaxNumber: | 3379930547 | ||||||||
| Practice Location | |||||||||
| Address1: | 1448 S COLLEGE RD | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705032920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372898222 | ||||||||
| FaxNumber: | 3372898223 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2009 | ||||||||
| LastUpdateDate: | 07/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | MD.208240 | LA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 1938360 | 05 | LA | MEDICAID |