Provider Demographics
NPI:1619486453
Name:BATON ROUGE GENERAL MEDICAL CENTER
Entity Type:Organization
Organization Name:BATON ROUGE GENERAL MEDICAL CENTER
Other - Org Name:BAYOU RADIATION ONCOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-763-4791
Mailing Address - Street 1:8490 PICARDY AVE
Mailing Address - Street 2:BLDG 200
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-763-4244
Mailing Address - Fax:225-237-1596
Practice Address - Street 1:3600 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-387-7280
Practice Address - Fax:225-237-1711
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BATON ROUGE GENERAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-25
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation