Healthcare Provider Details

I. General information

NPI: 1376567032
Provider Name (Legal Business Name): MICHAEL S HAYDEL, M.D., APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 BELANGER ST
HOUMA LA
70360-4412
US

IV. Provider business mailing address

PO BOX 1094
HOUMA LA
70361-1094
US

V. Phone/Fax

Practice location:
  • Phone: 985-223-3132
  • Fax: 985-223-3126
Mailing address:
  • Phone: 985-223-3132
  • Fax: 985-223-3126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD021195
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD020562
License Number StateLA

VIII. Authorized Official

Name: DR. MICHAEL STEPHEN HAYDEL
Title or Position: CEO
Credential: M.D.
Phone: 985-223-3132