Healthcare Provider Details

I. General information

NPI: 1497768147
Provider Name (Legal Business Name): RANI G WHITFIELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 EAST AIRPORT DR. SUITE 4
BATON ROUGE LA
70806
US

IV. Provider business mailing address

429 E AIRPORT AVE STE 4
BATON ROUGE LA
70806-4844
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-5500
  • Fax: 225-924-1243
Mailing address:
  • Phone: 225-765-5500
  • Fax: 225-924-1243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number28014
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: