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General NPI Number Information
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NPI Number | 1225382187
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL PAIN INSTITUTE LLC
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Dates
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Enumeration Date | 10/30/2012
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 8017 PICARDY AVE
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City | BATON ROUGE
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State | LA
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Zip | 70809-3538
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Country | US
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Telephone | 225-769-3636
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Fax | 225-771-8047
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Provider Business Mailing Address
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Address Line | 8017 PICARDY AVE
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City | BATON ROUGE
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State | LA
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Zip | 70809-3538
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Country | US
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Telephone | 225-769-3636
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Fax | 225-771-8047
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Authorized Official
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Title or Position | PHYSICIAN
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Name | BARRETT A. JOHNSTON
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Credential | MD
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Telephone | 225-769-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 204474
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License Number State | LA
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