Healthcare Provider Details

I. General information

NPI: 1548734213
Provider Name (Legal Business Name): URG-HAB SURGICAL SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2019
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8558 JEFFERSON HWY
BATON ROUGE LA
70809
US

IV. Provider business mailing address

8558 JEFFERSON HWY
BATON ROUGE LA
70809
US

V. Phone/Fax

Practice location:
  • Phone: 225-292-1969
  • Fax: 225-292-1960
Mailing address:
  • Phone: 225-292-1969
  • Fax: 225-292-1960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY B SONNIER
Title or Position: CEO-OWNER
Credential:
Phone: 225-292-1969