Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD.13268R | LA |
Y | 111NI0900X | Internist | MD.13268R | LA |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD.13268R | LA |
NPI | 1053529727 |
---|---|
Provider Name | Michael Edward Hymbaugh |
First Address | Baton Rouge, LA 70806-4013 |
Second Address | Baton Rouge, LA 70806-4043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 30/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1577278 | (05) | LA |
H43975 | (02) | LA |