Individual
PAUL RUSSELL HASTINGS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1108 CRYSTAL CT, SLIDELL, LA 70461-5092
(985) 781-0015
Mailing address
1108 CRYSTAL CT, SLIDELL, LA 70461-5092
(985) 781-0015
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
11326
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011326
MEDICAL LICENSE
LA
05
—
1178730
—
LA
Enumeration date
10/16/2006
Last updated
07/08/2007
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