MEDICARE: DR. ROBERT DOUGLAS HAYDEL JR. M.D.

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	207K00000X	Allergy & Immunology Physician	019894	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891791240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT DOUGLAS HAYDEL JR. M.D.

Provider Business Mailing Address
First Line	:	4752 HIGHWAY 311 STE 108
Second Line	:
City	:	HOUMA
State	:	LA
Zip	:	70360-2810
Country	:	US
Telephone Number	:	985-857-8271
Fax Number	:	985-655-8271

Provider Business Practice Location Address
First Line	:	4752 HIGHWAY 311 STE 108
Second Line	:
City	:	HOUMA
State	:	LA
Zip	:	70360-2810
Country	:	US
Telephone Number	:	985-857-8271
Fax Number	:	985-655-8271

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	01/29/2010

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Directions to “ DR. ROBERT DOUGLAS HAYDEL JR. M.D.” Practice Location

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