MEDICARE: JENNIFER PERONE 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	208600000X	Surgery Physician	BP10046338	TX
2	208600000X	Surgery Physician	ME150518	FL
3	208600000X	Surgery Physician	338603	LA
4	2086X0206X	Surgical Oncology Physician	338603	LA

General Provider Information

NPI Number	:	1518303106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER PERONE M.D.

Provider Business Mailing Address
First Line	:	17050 MEDICAL CENTER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-3221
Country	:	US
Telephone Number	:	225-761-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	17050 MEDICAL CENTER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-3221
Country	:	US
Telephone Number	:	225-761-5200
Fax Number	:

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

Provider Enumeration Date	:	05/22/2013
Last Update Date	:	10/05/2023

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