Healthcare Provider Details

I. General information

NPI: 1053538165
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: 04/19/2007
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 CHURCH ST STE B
ZACHARY LA
70791-2700
US

IV. Provider business mailing address

6300 MAIN ST
ZACHARY LA
70791-4037
US

V. Phone/Fax

Practice location:
  • Phone: 225-654-3607
  • Fax: 225-658-2262
Mailing address:
  • Phone: 225-658-4000
  • Fax: 225-658-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

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