Provider Demographics
NPI:1568631067
Name:GIANOLI, GERARD J (MD)
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:J
Last Name:GIANOLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17050 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-3221
Mailing Address - Country:US
Mailing Address - Phone:225-293-6973
Mailing Address - Fax:
Practice Address - Street 1:17050 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 315
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-3221
Practice Address - Country:US
Practice Address - Phone:225-293-6973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018767207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA43511062FOtherBLUE CROSS
LA1361763Medicaid
LA1361763Medicaid