Provider Demographics
NPI:1730231762
Name:MICHAEL HAYDEL MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:MICHAEL HAYDEL MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HAYDEL
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:504-349-6228
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD.
Mailing Address - Street 2:N208
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072
Mailing Address - Country:US
Mailing Address - Phone:504-349-6228
Mailing Address - Fax:504-349-6229
Practice Address - Street 1:1111 MEDICAL CENTER BLVD
Practice Address - Street 2:N208
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-349-6228
Practice Address - Fax:504-349-6229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1446602Medicaid