Healthcare Provider Details

I. General information

NPI: 1861837247
Provider Name (Legal Business Name): SHAWN LASSALLE SKARPNES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 NORTH BLVD.
BATON ROUGE LA
70806
US

IV. Provider business mailing address

3801 NORTH BLVD.
BATON ROUGE LA
70806
US

V. Phone/Fax

Practice location:
  • Phone: 225-387-7899
  • Fax:
Mailing address:
  • Phone: 225-387-7899
  • 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 StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: