Most Relevant Information
Provider Data
NPI Number: | 1003524398 |
Provider Name: | HAYDEN ROY INGRAM PA-C |
Entity Type: | Individual |
Taxonomy Code: | 363A00000X |
Specialty: | Physician Assistant |
License Number: |
Most Important Dates
Enumeration Date: | 11/07/2022 |
Last Updated: | 02/06/2024 |
Provider Practice Location
1188 DELTA LN
COVINGTON
LA
704337267
Practice Location Phone/Fax
Phone: | 5044813126 |
Fax: |
Provider Mailing Location
1188 DELTA LN
COVINGTON
LA
704337267
Provider Mailing Phone/Fax
Phone: | 5044813126 |
Fax: |