Provider Demographics
NPI:1811124290
Name:MEREDITH J HIXSON, MD., APMC
Entity type:Organization
Organization Name:MEREDITH J HIXSON, MD., APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:J
Authorized Official - Last Name:HIXSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-646-4490
Mailing Address - Street 1:700 GAUSE BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2853
Mailing Address - Country:US
Mailing Address - Phone:985-646-4490
Mailing Address - Fax:985-646-4491
Practice Address - Street 1:700 GAUSE BLVD STE 206
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2853
Practice Address - Country:US
Practice Address - Phone:985-646-4490
Practice Address - Fax:985-646-4491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13712R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1433730Medicaid
LA1433730Medicaid
LA5H710Medicare PIN