Provider Demographics
NPI:1174662936
Name:HILDENBRAND, JOHN CHRISTIAN IV (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRISTIAN
Last Name:HILDENBRAND
Suffix:IV
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:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70302-0028
Mailing Address - Country:US
Mailing Address - Phone:985-492-1200
Mailing Address - Fax:985-492-1212
Practice Address - Street 1:726 N ACADIA RD
Practice Address - Street 2:SUITE 1000
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-5009
Practice Address - Country:US
Practice Address - Phone:985-625-2200
Practice Address - Fax:985-625-2206
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA203722207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1012939Medicaid
LA1012939Medicaid