Healthcare Provider Details

I. General information

NPI: 1407057458
Provider Name (Legal Business Name): UTILIZATION MANAGEMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 BLUEBONNET BLVD., SUITE B
BATON ROUGE LA
70809
US

IV. Provider business mailing address

PO BOX 86758 4701 BLUEBONNET BLVD., SUITE B
BATON ROUGE LA
70879-6758
US

V. Phone/Fax

Practice location:
  • Phone: 225-296-0091
  • Fax: 225-291-9706
Mailing address:
  • Phone: 225-296-0091
  • Fax: 225-291-9706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number218
License Number StateLA

VIII. Authorized Official

Name: DR. CHARLES ROLAND HERRING
Title or Position: OWNER
Credential: D.C.
Phone: 225-296-0091