Organization
HAYDEL MEDICAL & PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARL G. HAYDEL JR. M.D. (PRESIDENT & CEO)
(888) 836-7015
Entity
Organization
Contact information
Practice address
1057 PAUL MAILLARD RD, LULING, LA 70070-4349
(888) 836-7015
Mailing address
1690 DUNLAWTON AVE, SUITE 130, PORT ORANGE, FL 32127-8979
(888) 836-7015
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
019061
LA
208VP0014X
Interventional Pain Medicine Physician
Primary
019061
LA
Other
Enumeration date
07/25/2013
Last updated
04/23/2014
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