Provider Demographics
NPI:1114121639
Name:ST HILAIRE, HUGO (MD,)
Entity Type:Individual
Prefix:
First Name:HUGO
Middle Name:
Last Name:ST HILAIRE
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TOKALON PL
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-3020
Mailing Address - Country:US
Mailing Address - Phone:504-287-7704
Mailing Address - Fax:504-387-6538
Practice Address - Street 1:4429 CLARA ST STE 330
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6957
Practice Address - Country:US
Practice Address - Phone:888-890-3437
Practice Address - Fax:843-727-3774
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA655002086S0122X
LA200218204E00000X, 208200000X
FLME147316208200000X
LAMD.200218208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1238767Medicaid
MS08534755Medicaid
MS08534755Medicaid
LA4N0977061Medicare PIN
LA4N097Medicare PIN