MEDICARE: THE EAR AND BALANCE INSTITUTE, 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	207YX0901X	Otology & Neurotology Physician

General Provider Information

NPI Number	:	1871762377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE EAR AND BALANCE INSTITUTE, INC

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	:	VICE-PRESIDENT
Name	:	GERARD J GIANOLI
Credential	:	MD
Telephone Number	:	225-293-6973

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

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