Provider Demographics
NPI:1376567032
Name:MICHAEL S HAYDEL, M.D., APMC
Entity Type:Organization
Organization Name:MICHAEL S HAYDEL, M.D., APMC
Other - Org Name:HAYDEL SPINE & PAIN SPECIALTY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:HAYDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-223-3132
Mailing Address - Street 1:PO BOX 1094
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-1094
Mailing Address - Country:US
Mailing Address - Phone:985-223-3132
Mailing Address - Fax:985-223-3126
Practice Address - Street 1:1022 BELANGER ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4412
Practice Address - Country:US
Practice Address - Phone:985-223-3132
Practice Address - Fax:985-223-3126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD021195207LP2900X
LAMD0205622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5N379Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
LAE68184Medicare UPIN