Healthcare Provider Details
I. General information
NPI: 1609175348
Provider Name (Legal Business Name): NATHAN HITE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/21/2011
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7777 HENNESSY BLVD STE 507
BATON ROUGE LA
70808-4366
US
IV. Provider business mailing address
5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US
V. Phone/Fax
- Phone: 225-767-1156
- Fax: 225-767-5980
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | 207721 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: