Healthcare Provider Details

I. General information

NPI: 1992477111
Provider Name (Legal Business Name): HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 MCHUGH RD STE C
ZACHARY LA
70791-5364
US

IV. Provider business mailing address

PO BOX 674924
DALLAS TX
75267-4924
US

V. Phone/Fax

Practice location:
  • Phone: 225-658-4065
  • Fax: 225-570-2986
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANK A CORCORAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 225-658-4303