Individual
DR. EDWARD RAY HERNANDEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15790 PAUL VEGA MD DR, HAMMOND, LA 70403-1434
(985) 230-6700
(985) 230-1528
Mailing address
PO BOX 2668, DEPARTMENT OF RADIOLOGY, HAMMOND, LA 70404-2668
(985) 230-6700
(985) 230-1528
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
201200
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07677021
—
MS
05
—
1409502
—
LA
01
—
P00606643
RR MEDICARE
—
Enumeration date
06/16/2006
Last updated
05/02/2017
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