| NPI | 1649317587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MICHAEL HAYDEL President 985-876-2150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 10882) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2008-08-26 |