Healthcare Provider Details

I. General information

NPI: 1457111809
Provider Name (Legal Business Name): KADE PASSMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 NORTH BLVD STE 200
BATON ROUGE LA
70806-3743
US

IV. Provider business mailing address

16463 NICHOLAS ST
PRAIRIEVILLE LA
70769-6809
US

V. Phone/Fax

Practice location:
  • Phone: 225-381-6620
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number347917
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: