1457523656 NPI number — DR. MAC-ELDER HILAIRE MD

Table of content: DR. MAC-ELDER HILAIRE MD (NPI 1457523656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457523656 NPI number — DR. MAC-ELDER HILAIRE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILAIRE
Provider First Name:
MAC-ELDER
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HILAIRE TOUSSAINT
Provider Other First Name:
MAC-ELDER
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1457523656
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 ABALONE LOOP
Provider Second Line Business Mailing Address:
MESCALERO HOSPITAL
Provider Business Mailing Address City Name:
MESCALERO
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88340
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-464-4441
Provider Business Mailing Address Fax Number:
575-464-4422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 ABALONE LOOP
Provider Second Line Business Practice Location Address:
MESCALERO HOSPITAL
Provider Business Practice Location Address City Name:
MESCALERO
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-464-4441
Provider Business Practice Location Address Fax Number:
575-464-4422
Provider Enumeration Date:
03/27/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  16729 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207QA0000X , with the licence number: 16729 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0505X , with the licence number: 16729 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)