Healthcare Provider Details

I. General information

NPI: 1982155867
Provider Name (Legal Business Name): BATON ROUGE GENERAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8595 PICARDY AVE SUITE 400
BATON ROUGE LA
70809-3670
US

IV. Provider business mailing address

8490 PICARDY AVE
BATON ROUGE LA
70809-3731
US

V. Phone/Fax

Practice location:
  • Phone: 225-767-0822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: KENDALL JOHNSON
Title or Position: VP CFO
Credential:
Phone: 225-237-1645