Provider Demographics
NPI:1003062274
Name:ADVANCED SURGICAL CARE OF BATON ROUGE,LLC
Entity Type:Organization
Organization Name:ADVANCED SURGICAL CARE OF BATON ROUGE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:COUVILLION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-768-8833
Mailing Address - Street 1:13170 DUTCHTWN PT AVE
Mailing Address - Street 2:332
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-0101
Mailing Address - Country:US
Mailing Address - Phone:225-953-0084
Mailing Address - Fax:225-612-8536
Practice Address - Street 1:7310 PERKINS ROAD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-953-0084
Practice Address - Fax:225-612-8536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical