Healthcare Provider Details

I. General information

NPI: 1205900925
Provider Name (Legal Business Name): BATON ROUGE COLON RECTAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 HENNESSY BLVD SUITE 206
BATON ROUGE LA
70808-4300
US

IV. Provider business mailing address

7777 HENNESSY BLVD SUITE 206
BATON ROUGE LA
70808-4300
US

V. Phone/Fax

Practice location:
  • Phone: 225-767-8997
  • Fax: 225-767-5980
Mailing address:
  • Phone: 225-767-8997
  • Fax: 225-767-5980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA B MCCHRISTIAN
Title or Position: RECEPTONIST
Credential:
Phone: 225-767-8997