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General NPI Number Information
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NPI Number | 1295833580
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Entity Type | Organization
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Legal Business Name | MARY BIRD PERKINS CANCER CENTER
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 4950 ESSEN LANE
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City | BATON ROUGE
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State | LA
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Zip | 70809
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Country | US
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Telephone | 225-215-1223
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Fax | 225-766-0218
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Provider Business Mailing Address
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Address Line | 5215 ESSEN LN STE 200
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City | BATON ROUGE
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State | LA
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Zip | 70809-3543
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Country | US
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Telephone | 225-215-1281
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Fax | 225-215-1380
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Authorized Official
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Title or Position | DECISION SUPPORT MANAGER
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Name | JACOB KRAFT
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Credential |
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Telephone | 225-215-1281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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