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General NPI Number Information
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NPI Number | 1801983226
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Entity Type | Organization
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Legal Business Name | ST. TAMMANY PATHOLOGY
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | 2644 S SHERWOOD FRST STE 121
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City | BATON ROUGE
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State | LA
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Zip | 70816-2248
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Country | US
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Telephone | 225-292-6354
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Fax | 225-293-1807
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Provider Business Mailing Address
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Address Line | 1202 S TYLER ST # 8T
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City | COVINGTON
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State | LA
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Zip | 70433-2330
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Country | US
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Telephone | 225-293-1075
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Fax | 225-293-1807
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DALE MORVANT
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Credential | M.D.
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Telephone | 225-293-1075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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