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General NPI Number Information
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NPI Number | 1841166774
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Entity Type | Organization
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Legal Business Name | PRACTICE LOGIC
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 10202 PERKINS ROWE STE E160
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City | BATON ROUGE
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State | LA
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Zip | 70810-2067
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Country | US
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Telephone | 225-451-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 10202 PERKINS ROWE STE E160
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City | BATON ROUGE
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State | LA
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Zip | 70810-2067
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Country | US
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Telephone | 225-451-2778
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Fax |
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Authorized Official
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Title or Position | CAO
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Name | KASEY ROBERTSON
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Credential |
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Telephone | 225-451-2778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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