Provider Demographics
NPI:1588028401
Name:HAIGHT, DEREK LEVOY
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:LEVOY
Last Name:HAIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 N ACADIA RD STE 2400
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-5078
Mailing Address - Country:US
Mailing Address - Phone:985-493-4544
Mailing Address - Fax:985-449-2513
Practice Address - Street 1:726 N ACADIA RD STE 2400
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-5078
Practice Address - Country:US
Practice Address - Phone:985-493-4080
Practice Address - Fax:985-493-4081
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA326272208VP0000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine