Healthcare Provider Details

I. General information

NPI: 1144083387
Provider Name (Legal Business Name): DPI OF LOUISIANA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2024
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8946 INTERLINE AVE STE C
BATON ROUGE LA
70809-1913
US

IV. Provider business mailing address

8946 INTERLINE AVE STE C
BATON ROUGE LA
70809-1913
US

V. Phone/Fax

Practice location:
  • Phone: 225-529-1143
  • Fax: 225-923-0060
Mailing address:
  • Phone: 225-529-1143
  • Fax: 225-923-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN SIKES
Title or Position: CEO
Credential: CRNA
Phone: 225-529-1149