Provider Demographics
NPI:1144233123
Name:HAYDEL, HENRY LAWRENCE II (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:LAWRENCE
Last Name:HAYDEL
Suffix:II
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 1:1001 SCHOOL STREET
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4691
Mailing Address - Country:US
Mailing Address - Phone:985-868-1540
Mailing Address - Fax:985-876-0759
Practice Address - Street 1:1001 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4691
Practice Address - Country:US
Practice Address - Phone:985-868-1540
Practice Address - Fax:985-876-0759
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020860207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA200027949OtherMEDICARE RR
LA1679356Medicaid
E97507Medicare UPIN
LA200027949OtherMEDICARE RR
LA0401740001Medicare NSC
LA5W839Medicare PIN