MEDICARE: BATON ROUGE ORTHOPAEDIC CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207X00000X	Orthopaedic Surgery Physician
2	335E00000X	Prosthetic/Orthotic Supplier
3	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215102033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BATON ROUGE ORTHOPAEDIC CLINIC

Provider Business Mailing Address
First Line	:	8080 BLUEBONNET BLVD
Second Line	:	SUITE 1000
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-7827
Country	:	US
Telephone Number	:	225-924-2424
Fax Number	:	225-408-7984

Provider Business Practice Location Address
First Line	:	4920 CHURCH ST STE E
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-3580
Country	:	US
Telephone Number	:	225-658-1808
Fax Number	:	225-658-5922

Authorized Official
Title or Position	:	CEO
Name	:	SAMUEL WILLIAMSON
Credential	:
Telephone Number	:	225-924-2424

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	03/11/2025

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Directions to “BATON ROUGE ORTHOPAEDIC CLINIC ” Practice Location

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