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NPI Code Detail

MEDICARE: RANDALL D. LEA, M.D. PC

MEDICARE: RANDALL D. LEA, M.D. PC
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
1207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1306078092
Entity Type Code : Organization
Provider Name (Legal Business Name) : RANDALL D. LEA, M.D. PC
Provider Business Mailing Address
First Line : 14635 S HARRELLS FERRY RD
Second Line : SUITE 3A
City : BATON ROUGE
State : LA
Zip : 70816-2959
Country : US
Telephone Number : 225-754-8888
Fax Number : 225-751-5847
Provider Business Practice Location Address
First Line : 14635 S HARRELLS FERRY RD
Second Line : STE 3A
City : BATON ROUGE
State : LA
Zip : 70816-2959
Country : US
Telephone Number : 225-754-8888
Fax Number : 225-751-5847
Authorized Official
Title or Position : OWNER/MANAGER
Name : DR. RANDALL D. LEA
Credential : M.D.
Telephone Number : 225-754-8888
Provider Enumeration Date : 08/14/2009
Last Update Date : 10/13/2009

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