MEDICARE: GERARD J GIANOLI MD

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	207YX0901X	Otology & Neurotology Physician	018767	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	43511062F	OTHER	LA	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568631067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERARD J GIANOLI MD

Provider Business Mailing Address
First Line	:	17050 MEDICAL CENTER DR
Second Line	:	SUITE 315
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-3221
Country	:	US
Telephone Number	:	225-293-6973
Fax Number	:

Provider Business Practice Location Address
First Line	:	17050 MEDICAL CENTER DR
Second Line	:	SUITE 315
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-3221
Country	:	US
Telephone Number	:	225-293-6973
Fax Number	:

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

Provider Enumeration Date	:	02/28/2008
Last Update Date	:	02/28/2008

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