Healthcare Provider Details

I. General information

NPI: 1134456999
Provider Name (Legal Business Name): FRANK LYONS GREENWAY III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2009
Last Update Date: 11/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 PERKINS RD PENNINGTON CENTER
BATON ROUGE LA
70808-4124
US

IV. Provider business mailing address

6400 PERKINS RD PENNINGTON CENTER
BATON ROUGE LA
70808-4124
US

V. Phone/Fax

Practice location:
  • Phone: 225-763-2578
  • Fax: 225-763-3022
Mailing address:
  • Phone: 225-763-2578
  • Fax: 225-763-3022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number11090R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: