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General NPI Number Information
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NPI Number | 1235159252
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Entity Type | Individual
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Provider Name | MICHAEL L HAWTHORNE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 855 BELANGER ST SUITE 208
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City | HOUMA
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State | LA
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Zip | 70360-4463
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Country | US
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Telephone | 985-872-6210
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Fax | 985-876-7743
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Provider Business Mailing Address
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Address Line | 3525 PRYTANIA ST STE 526
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City | NEW ORLEANS
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State | LA
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Zip | 70115-8127
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Country | US
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Telephone | 985-872-6210
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Fax | 985-876-7743
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 33315
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License Number State | LA
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