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General NPI Number Information
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NPI Number | 1073026639
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Entity Type | Organization
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Legal Business Name | MID CITY SPECIALTY CENTER, LLC
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 01/02/2018
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Provider Practice Location Address
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Address Line | 3600 FLORIDA BLVD STE 2000
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City | BATON ROUGE
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State | LA
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Zip | 70806-3842
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Country | US
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Telephone | 225-381-6701
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Fax | 225-381-6702
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Provider Business Mailing Address
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Address Line | 3600 FLORIDA BLVD STE 2000
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City | BATON ROUGE
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State | LA
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Zip | 70806-3842
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Country | US
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Telephone | 225-381-6701
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Fax | 225-381-6702
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Authorized Official
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Title or Position | RCC
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Name | HEATH VEULEMAN
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Credential |
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Telephone | 318-447-1598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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