Provider Demographics
NPI:1487666277
Name:PEDIATRIC HOSPITALISTS OF LOUISIANA, LLC
Entity Type:Organization
Organization Name:PEDIATRIC HOSPITALISTS OF LOUISIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SANDERS
Authorized Official - Last Name:CRAPANZANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-709-8633
Mailing Address - Street 1:8200 CONSTANTIN BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3481
Mailing Address - Country:US
Mailing Address - Phone:225-709-8633
Mailing Address - Fax:225-709-8634
Practice Address - Street 1:8200 CONSTANTIN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3481
Practice Address - Country:US
Practice Address - Phone:225-709-8633
Practice Address - Fax:225-709-8634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1444961Medicaid
LA1444961Medicaid