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General NPI Number Information
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NPI Number | 1558497289
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Entity Type | Organization
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Legal Business Name | HAIK & TERRELL, LLC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1046 PAUL MAILLARD RD
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City | LULING
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State | LA
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Zip | 70070
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Country | US
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Telephone | 985-785-8444
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Fax | 985-785-8468
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Provider Business Mailing Address
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Address Line | 2800 VETERANS BLVD SUITE 209
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City | METAIRIE
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State | LA
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Zip | 70002-6176
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Country | US
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Telephone | 504-833-2532
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Fax | 504-833-9232
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Authorized Official
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Title or Position | OWNER
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Name | DR. WALTER LEE TERRELL III
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Credential | M.D.
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Telephone | 504-833-2532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 18190-845
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License Number State | LA
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