Provider Demographics
NPI:1699760520
Name:MENARD, RONALD DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DAVID
Last Name:MENARD
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 1:1514 JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:9001 SUMMA AVENUE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-8210
Practice Address - Country:US
Practice Address - Phone:225-761-5480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0100745OtherUNITED HEALTHCARE
LA1319384Medicaid
LA5024620OtherAETNA
MS06256682Medicaid
LA7740707OtherCIGNA (PAL ID#)
LA53507Medicare ID - Type Unspecified
LA1319384Medicaid
LA7740707OtherCIGNA (PAL ID#)