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NPI Code Detail

MEDICARE: JOHN FORYT CRNA

MEDICARE: JOHN FORYT CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist043963LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063519650
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN FORYT CRNA
Provider Business Mailing Address
First Line : 9050 AIRLINE HWY
Second Line :
City : BATON ROUGE
State : LA
Zip : 70815-4103
Country : US
Telephone Number : 225-929-7210
Fax Number : 225-930-7524
Provider Business Practice Location Address
First Line : 8212 KELWOOD AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-4801
Country : US
Telephone Number : 225-929-7600
Fax Number : 225-930-7524
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2006
Last Update Date : 07/09/2007

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Directions to “ JOHN FORYT CRNA” Practice Location

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