# MICHAEL S HANEMANN JR MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023247582
- **Authorized official:** DR. MICHAEL STEPHEN HANEMANN JR. M.D. (DOCTOR)
- **Authorized official phone:** (504) 460-3821

## Contact information

- **Practice address:** 5233 DIJON DR, BATON ROUGE, LA 70808-4692
- **Practice address phone:** (225) 766-2166
- **Practice address fax:** (225) 766-2164
- **Mailing address:** 5233 DIJON DR, BATON ROUGE, LA 70808-4692
- **Mailing address phone:** (225) 766-2166
- **Mailing address fax:** (225) 766-2164

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 025571 | LA | Yes |

## Other

- **Enumeration date:** 07/06/2009
- **Last updated:** 07/06/2009