Healthcare Provider Details

I. General information

NPI: 1811994759
Provider Name (Legal Business Name): CHRISTOPHER HEBERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 RUE LOUIS XIV
LAFAYETTE LA
70508-5739
US

IV. Provider business mailing address

108 RUE LOUIS XIV
LAFAYETTE LA
70508-5739
US

V. Phone/Fax

Practice location:
  • Phone: 337-235-8007
  • Fax: 855-270-5479
Mailing address:
  • Phone: 337-235-8007
  • Fax: 855-270-5479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number020990
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: