Healthcare Provider Details

I. General information

NPI: 1295786655
Provider Name (Legal Business Name): JOHN KYLE SCHWAB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 BLUEBONNET BLVD
BATON ROUGE LA
70809-9632
US

IV. Provider business mailing address

4660 BLUEBONNET BLVD
BATON ROUGE LA
70809-9632
US

V. Phone/Fax

Practice location:
  • Phone: 225-767-8550
  • Fax: 225-767-8556
Mailing address:
  • Phone: 225-767-8550
  • Fax: 225-767-8556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License NumberMD.13571R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: