Healthcare Provider Details

I. General information

NPI: 1114121639
Provider Name (Legal Business Name): HUGO ST HILAIRE MD,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4429 CLARA ST STE 330
NEW ORLEANS LA
70115-6957
US

IV. Provider business mailing address

2 TOKALON PL
METAIRIE LA
70001-3020
US

V. Phone/Fax

Practice location:
  • Phone: 888-890-3437
  • Fax: 843-727-3774
Mailing address:
  • Phone: 504-287-7704
  • Fax: 504-387-6538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number200218
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME147316
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number200218
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD.200218
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number65500
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: