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NPI Code Detail

MEDICARE: K GERALD HAYDEL MD APC

MEDICARE: K GERALD HAYDEL MD APC
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
1208D00000XGeneral Practice Physician008369LA

General Provider Information

NPI Number : 1568429918
Entity Type Code : Organization
Provider Name (Legal Business Name) : K GERALD HAYDEL MD APC
Provider Business Mailing Address
First Line : PO BOX 380
Second Line :
City : GRAND ISLE
State : LA
Zip : 70358
Country : US
Telephone Number : 985-787-3585
Fax Number :
Provider Business Practice Location Address
First Line : 502 BARROW ST
Second Line :
City : HOUMA
State : LA
Zip : 70360-4606
Country : US
Telephone Number : 985-868-4890
Fax Number :
Authorized Official
Title or Position : PHYSICIAN
Name : DR. KARL GERALD HAYDEL SR.
Credential : MD
Telephone Number : 985-868-4890
Provider Enumeration Date : 04/28/2006
Last Update Date : 03/19/2009

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