MEDICARE: DR. RONALD JOSEPH HAYDEL II D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1470	LA

General Provider Information

NPI Number	:	1962661389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD JOSEPH HAYDEL II D.C.

Provider Business Mailing Address
First Line	:	4752 HIGHWAY 311
Second Line	:	SUITE 104
City	:	HOUMA
State	:	LA
Zip	:	70360-2810
Country	:	US
Telephone Number	:	985-346-4844
Fax Number	:	985-346-4845

Provider Business Practice Location Address
First Line	:	4752 HIGHWAY 311
Second Line	:	SUITE 104
City	:	HOUMA
State	:	LA
Zip	:	70360-2810
Country	:	US
Telephone Number	:	985-346-4844
Fax Number	:	985-346-4845

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2008
Last Update Date	:	09/30/2010

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