MEDICARE: BATON ROUGE GENERAL PHYSICIANS, INC.

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1518219112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BATON ROUGE GENERAL PHYSICIANS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 4869
Second Line	:	DEPT: 235
City	:	HOUSTON
State	:	TX
Zip	:	77210-4869
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8490 PICARDY AVE
Second Line	:	SUITE 600D
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3731
Country	:	US
Telephone Number	:	225-819-1175
Fax Number	:

Authorized Official
Title or Position	:	C.F.O.
Name	:	KENDALL A. JOHNSON
Credential	:
Telephone Number	:	225-237-1645

Provider Enumeration Date	:	10/05/2012
Last Update Date	:	12/26/2018

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