Provider Demographics
NPI:1235159252
Name:HAWTHORNE, MICHAEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:HAWTHORNE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3525 PRYTANIA ST
Mailing Address - Street 2:STE 526
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-8127
Mailing Address - Country:US
Mailing Address - Phone:985-872-6210
Mailing Address - Fax:985-876-7743
Practice Address - Street 1:855 BELANGER ST
Practice Address - Street 2:SUITE 208
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4463
Practice Address - Country:US
Practice Address - Phone:985-872-6210
Practice Address - Fax:985-876-7743
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2017-04-13
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Provider Licenses
StateLicense IDTaxonomies
LA33315207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP00385330OtherRAILROAD MEDICARE
LA1571431Medicaid
LA1571431Medicaid