MEDICARE: JESSICA BABINEAUX M.D.

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
1	174400000X	Specialist	199992	LA

General Provider Information

NPI Number	:	1497940209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA BABINEAUX M.D.

Provider Business Mailing Address
First Line	:	9456 JEFFERSON HWY STE A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-2883
Country	:	US
Telephone Number	:	225-325-3596
Fax Number	:	252-246-2412

Provider Business Practice Location Address
First Line	:	9456 JEFFERSON HWY STE A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-2883
Country	:	US
Telephone Number	:	225-325-3596
Fax Number	:	225-224-6241

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2007
Last Update Date	:	11/12/2020

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