Healthcare Provider Details

I. General information

NPI: 1124243837
Provider Name (Legal Business Name): ROSALIND ANNETTE CROPPER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 09/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11861 COURSEY BLVD
BATON ROUGE LA
70816-4404
US

IV. Provider business mailing address

103 TERRY PKWY STE B
TERRYTOWN LA
70056-2522
US

V. Phone/Fax

Practice location:
  • Phone: 225-241-2328
  • Fax:
Mailing address:
  • Phone: 504-352-2997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number06941R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: