MEDICARE: HAROLD J BAYONNE JR MD APMC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	200303	LA

General Provider Information

NPI Number	:	1356886774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAROLD J BAYONNE JR MD APMC

Provider Business Mailing Address
First Line	:	PO BOX 570
Second Line	:
City	:	LAKE FOREST
State	:	IL
Zip	:	60045-0570
Country	:	US
Telephone Number	:	224-231-4363
Fax Number	:	866-642-1525

Provider Business Practice Location Address
First Line	:	1601 LOUISVILLE AVE
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-6027
Country	:	US
Telephone Number	:	318-998-5555
Fax Number	:	318-737-7039

Authorized Official
Title or Position	:	OWNER
Name	:	HAROLD BAYONNE JR.
Credential	:
Telephone Number	:	224-231-4363

Provider Enumeration Date	:	12/20/2016
Last Update Date	:	12/06/2023

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