Provider Demographics
NPI:1891878427
Name:HYATT, JAMES B (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:HYATT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 AUDUBON AVE STE S1
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4957
Mailing Address - Country:US
Mailing Address - Phone:985-492-6170
Mailing Address - Fax:985-492-6177
Practice Address - Street 1:1101 AUDUBON AVE STE S1
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4957
Practice Address - Country:US
Practice Address - Phone:985-492-6170
Practice Address - Fax:985-492-6177
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2024-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA320747207Q00000X, 2083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2510657Medicaid
LAP14872Medicare UPIN
LA1624985Medicaid