Healthcare Provider Details

I. General information

NPI: 1659456242
Provider Name (Legal Business Name): BERNARD S HOJAILI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 E MAIN ST STE C
NEW IBERIA LA
70560-4064
US

IV. Provider business mailing address

PO BOX 11937
NEW IBERIA LA
70562-1937
US

V. Phone/Fax

Practice location:
  • Phone: 337-560-1711
  • Fax: 337-359-9102
Mailing address:
  • Phone: 337-560-1711
  • Fax: 337-359-9102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number200973
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: