Organization · Type 2 NPI
Our Lady of the Lake Physician Group LLC
Pediatric Emergency Medicine (Pediatrics) Physician · Baton Rouge, LA
NPI number
1912282831
Active
Practice location
7777 Hennessy Blvd, Ste 6002
Baton Rouge, LA 70808-4300
Fax (225) 766-5645
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician Primary | 2080P0204X | None listed |
Pediatric Emergency Medicine (Pediatrics) Physician: A pediatrician who has special qualifications to manage emergencies in infants and children.
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About NPI 1912282831
Our Lady of the Lake Physician Group LLC's National Provider Identifier is 1912282831, issued on Oct 12, 2011. The primary taxonomy on file is Pediatric Emergency Medicine (Pediatrics) Physician (2080P0204X), and the practice location is in Baton Rouge, LA. The record was last updated on Oct 12, 2011.