MEDICARE: PATRICK LAYNE TASSIN 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	207V00000X	Obstetrics & Gynecology Physician	304365	LA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1639412059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK LAYNE TASSIN MD

Provider Business Mailing Address
First Line	:	500 RUE DE LA VIE ST
Second Line	:	SUITE 413
City	:	BATON ROUGE
State	:	LA
Zip	:	70817-5127
Country	:	US
Telephone Number	:	225-215-7960
Fax Number	:

Provider Business Practice Location Address
First Line	:	3304 MASONIC DR STE 4001
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-4255
Country	:	US
Telephone Number	:	318-443-7222
Fax Number	:	318-443-7641

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

Provider Enumeration Date	:	04/03/2013
Last Update Date	:	11/26/2019

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