Healthcare Provider Details

I. General information

NPI: 1225050727
Provider Name (Legal Business Name): LEO T. HAPPEL JR. PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1542 TULANE AVE BOX T2-1
NEW ORLEANS LA
70112-2865
US

IV. Provider business mailing address

1340 POYDRAS ST
NEW ORLEANS LA
70112-1221
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-4080
  • Fax:
Mailing address:
  • Phone: 504-412-1860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number1111
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: