Healthcare Provider Details

I. General information

NPI: 1952213563
Provider Name (Legal Business Name): WOMAN'S OB/GYN CLINIC - ZACHARY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 MAIN ST STE 2000
ZACHARY LA
70791-4092
US

IV. Provider business mailing address

100 WOMANS WAY
BATON ROUGE LA
70817-5100
US

V. Phone/Fax

Practice location:
  • Phone: 225-658-1303
  • Fax:
Mailing address:
  • Phone: 225-927-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: NINA DUSANG
Title or Position: EVP-CFO
Credential:
Phone: 225-924-8555