Healthcare Provider Details

I. General information

NPI: 1891772547
Provider Name (Legal Business Name): NOVAMED SURGERY CENTER OF BATON ROUGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8748 BLUEBONNET BLVD
BATON ROUGE LA
70810-2817
US

IV. Provider business mailing address

8748 BLUEBONNET BLVD
BATON ROUGE LA
70810-2817
US

V. Phone/Fax

Practice location:
  • Phone: 225-329-2900
  • Fax: 225-329-2901
Mailing address:
  • Phone: 225-329-2900
  • Fax: 225-329-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number140
License Number StateLA

VIII. Authorized Official

Name: JENNIFER BOYD BALDOCK
Title or Position: OFFICER AND AUTHORIZED OFFICIAL
Credential:
Phone: 615-234-5900