Individual
DR. MARK EVANS HAILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15790 PAUL VEGA MD DR, HAMMOND, LA 70403-1434
(985) 230-1332
(985) 230-1334
Mailing address
15790 PAUL VEGA MD DR, HAMMOND, LA 70403-1434
(985) 345-2700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.016204
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06221500
—
MS
01
—
080119898
RR MEDICARE
—
05
—
1319945
—
LA
Enumeration date
08/08/2006
Last updated
10/06/2021
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