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General NPI Number Information
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NPI Number | 1306078092
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Entity Type | Organization
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Legal Business Name | RANDALL D. LEA, M.D. PC
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Dates
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Enumeration Date | 08/14/2009
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 14635 S HARRELLS FERRY RD STE 3A
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City | BATON ROUGE
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State | LA
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Zip | 70816-2959
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Country | US
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Telephone | 225-754-8888
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Fax | 225-751-5847
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Provider Business Mailing Address
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Address Line | 14635 S HARRELLS FERRY RD SUITE 3A
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City | BATON ROUGE
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State | LA
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Zip | 70816-2959
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Country | US
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Telephone | 225-754-8888
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Fax | 225-751-5847
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. RANDALL D. LEA
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Credential | M.D.
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Telephone | 225-754-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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