Provider Demographics
NPI:1538315957
Name:BATON ROUGE SURGICAL GROUP
Entity Type:Organization
Organization Name:BATON ROUGE SURGICAL GROUP
Other - Org Name:SIDNEY O ROSS, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DENITTA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-763-4820
Mailing Address - Street 1:8595 PICARDY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3670
Mailing Address - Country:US
Mailing Address - Phone:225-763-4820
Mailing Address - Fax:225-763-4819
Practice Address - Street 1:8595 PICARDY AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3670
Practice Address - Country:US
Practice Address - Phone:225-763-4820
Practice Address - Fax:225-763-4819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.03360R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty