Healthcare Provider Details

I. General information

NPI: 1528229747
Provider Name (Legal Business Name): LSU HEALTH SCIENCES CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 AIRLINE HWY
BATON ROUGE LA
70805-2408
US

IV. Provider business mailing address

5825 AIRLINE HWY
BATON ROUGE LA
70805-2408
US

V. Phone/Fax

Practice location:
  • Phone: 225-358-1297
  • Fax: 225-358-1198
Mailing address:
  • Phone: 225-358-1297
  • Fax: 225-358-1198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberRN065691
License Number StateLA

VIII. Authorized Official

Name: DR. STEVEN B SPEDALE
Title or Position: CHIEF OF NEONATOLGY
Credential: MD
Phone: 225-358-1297