MEDICARE: DR. RUFUS LESTER HIXON III 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	208000000X	Pediatrics Physician	12087R	LA
2	2080P0203X	Pediatric Critical Care Medicine Physician	12087R	LA
3	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	MD.12087R	LA
4	2080P0202X	Pediatric Cardiology Physician	12087R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730188806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUFUS LESTER HIXON III M.D.

Provider Business Mailing Address
First Line	:	8200 CONSTANTIN BLVD STE 200
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3481
Country	:	US
Telephone Number	:	225-767-6700
Fax Number	:	225-767-6721

Provider Business Practice Location Address
First Line	:	8200 CONSTANTIN BLVD STE 200
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3481
Country	:	US
Telephone Number	:	225-767-6700
Fax Number	:	225-767-6721

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	03/29/2022

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