Healthcare Provider Details

I. General information

NPI: 1750355632
Provider Name (Legal Business Name): KARL G HAYDEL JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8166 MAIN STREET
HOUMA LA
70360
US

IV. Provider business mailing address

PO BOX 6037
HOUMA LA
70361-6037
US

V. Phone/Fax

Practice location:
  • Phone: 985-873-4141
  • Fax: 985-851-4307
Mailing address:
  • Phone: 985-873-4235
  • Fax: 985-851-4307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number19061
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD.019061
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: