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General NPI Number Information
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NPI Number | 1821011743
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Entity Type | Individual
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Provider Name | AMY HAYNIE PHELAN MD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 3434 PRYTANIA ST STE 105
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City | NEW ORLEANS
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State | LA
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Zip | 70115-3533
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Country | US
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Telephone | 504-897-8412
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 PRYTANIA ST STE 35
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City | NEW ORLEANS
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State | LA
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Zip | 70115-3678
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Country | US
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Telephone | 504-897-8412
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Fax | 504-249-5311
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | MD.14023R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | L8889
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License Number State | TX
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