Provider Demographics
NPI:1962661389
Name:HAYDEL, RONALD JOSEPH II (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JOSEPH
Last Name:HAYDEL
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:RONNIE
Other - Middle Name:J
Other - Last Name:HAYDEL
Other - Suffix:II
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:4752 HIGHWAY 311
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2810
Mailing Address - Country:US
Mailing Address - Phone:985-346-4844
Mailing Address - Fax:985-346-4845
Practice Address - Street 1:4752 HIGHWAY 311
Practice Address - Street 2:SUITE 104
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2810
Practice Address - Country:US
Practice Address - Phone:985-346-4844
Practice Address - Fax:985-346-4845
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor