Healthcare Provider Details

I. General information

NPI: 1003817230
Provider Name (Legal Business Name): RICHARD W. FOSTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 PARK ROWE AVE STE 200
BATON ROUGE LA
70810-1685
US

IV. Provider business mailing address

PO BOX 98509
BATON ROUGE LA
70884-9509
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-2200
  • Fax: 225-768-2185
Mailing address:
  • Phone: 225-769-2200
  • Fax: 225-768-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number18484
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number18484
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number0101032902
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101032902
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD.07009R
License Number StateLA
# 6
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberMD.07009R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: