Healthcare Provider Details

I. General information

NPI: 1013995646
Provider Name (Legal Business Name): CHRISTOPHER MILES MCCANLESS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 HENNESSY BLVD STE 6000
BATON ROUGE LA
70808-4366
US

IV. Provider business mailing address

7456 S BOCAGE CT
BATON ROUGE LA
70809-1165
US

V. Phone/Fax

Practice location:
  • Phone: 225-757-0343
  • Fax: 225-757-8354
Mailing address:
  • Phone: 225-231-2488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number020150
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number020150
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: