Provider Demographics
NPI:1558497289
Name:HAIK & TERRELL, LLC
Entity Type:Organization
Organization Name:HAIK & TERRELL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:504-833-2532
Mailing Address - Street 1:2800 VETERANS BLVD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6176
Mailing Address - Country:US
Mailing Address - Phone:504-833-2532
Mailing Address - Fax:504-833-9232
Practice Address - Street 1:1046 PAUL MAILLARD RD
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070
Practice Address - Country:US
Practice Address - Phone:985-785-8444
Practice Address - Fax:985-785-8468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18190-845174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1448010Medicaid
LADE4771OtherRAILROAD MEDICARE
LADE4771OtherRAILROAD MEDICARE
LA=========0OtherBLUE CROSS