Healthcare Provider Details
I. General information
NPI: 1972795250
Provider Name (Legal Business Name): JOSEPH RYAN SHOWS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/10/2007
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4950 ESSEN LN SUITE 300
BATON ROUGE LA
70809-3738
US
IV. Provider business mailing address
5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US
V. Phone/Fax
- Phone: 225-757-0343
- Fax: 225-757-8354
- Phone: 225-765-5727
- Fax: 225-765-9196
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | MD.202207 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: