Healthcare Provider Details

I. General information

NPI: 1639301633
Provider Name (Legal Business Name): M. GILES FORT, M.D. A P M C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 AIRLINE HWY SUITE 210
BATON ROUGE LA
70815-4114
US

IV. Provider business mailing address

9000 AIRLINE HWY SUITE 210
BATON ROUGE LA
70815-4114
US

V. Phone/Fax

Practice location:
  • Phone: 225-216-3006
  • Fax: 225-216-1081
Mailing address:
  • Phone: 225-216-3006
  • Fax: 225-216-1081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MILTON GILES FORT
Title or Position: OWNER
Credential: M.D.
Phone: 225-216-3006