Healthcare Provider Details

I. General information

NPI: 1619137924
Provider Name (Legal Business Name): JACOB M. ESTES, M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JACOB MICHAEL ESTES
Title or Position: GYN ONCOLOGIST
Credential: M.D.
Phone: 225-216-3006