Healthcare Provider Details

I. General information

NPI: 1912197575
Provider Name (Legal Business Name): BARTON LLOYD WAX M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 SCHOOL ST
HOUMA LA
70360-4629
US

IV. Provider business mailing address

1001 SCHOOL ST
HOUMA LA
70360-4629
US

V. Phone/Fax

Practice location:
  • Phone: 985-868-1540
  • Fax: 985-873-2968
Mailing address:
  • Phone: 985-868-1540
  • Fax: 985-873-2968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number203240
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number203240
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: