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NPI Code Detail

MEDICARE: MARY BIRD PERKINS CANCER CENTER

MEDICARE: MARY BIRD PERKINS CANCER CENTER
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
12085R0001XRadiation Oncology Physician
22085R0202XDiagnostic Radiology Physician
32085N0904XNuclear Radiology Physician
4291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1295833580
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARY BIRD PERKINS CANCER CENTER
Provider Business Mailing Address
First Line : 5215 ESSEN LN STE 200
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3543
Country : US
Telephone Number : 225-215-1281
Fax Number : 225-215-1380
Provider Business Practice Location Address
First Line : 4950 ESSEN LANE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809
Country : US
Telephone Number : 225-215-1223
Fax Number : 225-766-0218
Authorized Official
Title or Position : DECISION SUPPORT MANAGER
Name : JACOB KRAFT
Credential :
Telephone Number : 225-215-1281
Provider Enumeration Date : 09/20/2006
Last Update Date : 12/12/2025

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Directions to “MARY BIRD PERKINS CANCER CENTER ” Practice Location

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