Provider Demographics
NPI:1871930305
Name:HYMEL, RENE J (DPM)
Entity type:Individual
Prefix:DR
First Name:RENE
Middle Name:J
Last Name:HYMEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79225 LADY LN
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:LA
Mailing Address - Zip Code:70437-3115
Mailing Address - Country:US
Mailing Address - Phone:985-807-5330
Mailing Address - Fax:
Practice Address - Street 1:79225 LADY LN
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:LA
Practice Address - Zip Code:70437-3115
Practice Address - Country:US
Practice Address - Phone:985-807-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA303928213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2432729Medicaid
LA540683YH64Medicare PIN