Provider Demographics
NPI:1154371219
Name:FLYNN, J.MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:J.MICHAEL
Middle Name:
Last Name:FLYNN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2834
Mailing Address - Country:US
Mailing Address - Phone:985-223-3811
Mailing Address - Fax:985-223-3877
Practice Address - Street 1:567 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2834
Practice Address - Country:US
Practice Address - Phone:985-223-3811
Practice Address - Fax:985-223-3877
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1938793Medicaid
LA59463Medicare PIN
LA1938793Medicaid