Healthcare Provider Details

I. General information

NPI: 1407965502
Provider Name (Legal Business Name): MARIE-LOUISE ALIXE HAYMON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HENRY CLAY AVE
NEW ORLEANS LA
70118-5720
US

IV. Provider business mailing address

46 CHATEAU MOUTON DR
KENNER LA
70065-1903
US

V. Phone/Fax

Practice location:
  • Phone: 504-896-9566
  • Fax: 504-896-9768
Mailing address:
  • Phone: 504-469-1435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number019895
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: