Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD.204078 | LA |
NPI | 1740446228 |
---|---|
Provider Name | Laura Toups Hetzler |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Baton Rouge, LA 70809-3738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1067814 | (05) | LA |