Provider Demographics
NPI:1710907399
Name:HAINSWORTH, BARBARA ELLEN (MD,)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ELLEN
Last Name:HAINSWORTH
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:MRS
Other - First Name:BARBARA
Other - Middle Name:ELLEN
Other - Last Name:RESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:612 RUE SAINT MARTIN
Mailing Address - Street 2:APARTMENT C
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-5363
Mailing Address - Country:US
Mailing Address - Phone:985-345-4240
Mailing Address - Fax:
Practice Address - Street 1:612 RUE SAINT MARTIN
Practice Address - Street 2:APARTMENT C
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-345-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04638R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1361275Medicaid
LAWILL BE REACTIVATEDMedicare ID - Type Unspecified
LAG01738Medicare UPIN