=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346045705
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAROLD J BAYONNE JR MD APMC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2025
-----------------------------------------------------
Last Update Date | 02/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1613 LOUISVILLE AVE
-----------------------------------------------------
City | MONROE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71201-6027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-855-3291
-----------------------------------------------------
Fax | 318-737-7039
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1613 LOUISVILLE AVE
-----------------------------------------------------
City | MONROE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71201-6027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-855-3291
-----------------------------------------------------
Fax | 318-737-7039
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HAROLD BAYONNE JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 318-855-3291
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------