Healthcare Provider Details

I. General information

NPI: 1639933005
Provider Name (Legal Business Name): PATRICK BUZBEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 CORA DR
BATON ROUGE LA
70815-4201
US

IV. Provider business mailing address

150 CORA DR
BATON ROUGE LA
70815-4201
US

V. Phone/Fax

Practice location:
  • Phone: 225-387-1611
  • Fax: 225-343-5300
Mailing address:
  • Phone: 225-387-1611
  • Fax: 225-343-5300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: