Provider Demographics
NPI:1811965932
Name:HAYDEL, SARAH ALEXANDER (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ALEXANDER
Last Name:HAYDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 VALHI BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-5974
Mailing Address - Country:US
Mailing Address - Phone:985-223-3871
Mailing Address - Fax:985-580-3005
Practice Address - Street 1:578 VALHI BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-5974
Practice Address - Country:US
Practice Address - Phone:985-223-3871
Practice Address - Fax:985-580-3005
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024925207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAL15395Medicare UPIN
LA4J005Medicare ID - Type Unspecified