Healthcare Provider Details

I. General information

NPI: 1215199724
Provider Name (Legal Business Name): BATON ROUGE GENERAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 FLORIDA BLVD
BATON ROUGE LA
70806-3842
US

IV. Provider business mailing address

3600 FLORIDA BLVD
BATON ROUGE LA
70806-3842
US

V. Phone/Fax

Practice location:
  • Phone: 225-381-2615
  • Fax:
Mailing address:
  • Phone: 225-381-2615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. KENDALL JOHNSON
Title or Position: C.F.O.
Credential:
Phone: 225-237-1645