Provider Demographics
NPI:1639412059
Name:TASSIN, PATRICK LAYNE (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:LAYNE
Last Name:TASSIN
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 1:500 RUE DE LA VIE ST
Mailing Address - Street 2:SUITE 413
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-5127
Mailing Address - Country:US
Mailing Address - Phone:225-215-7960
Mailing Address - Fax:
Practice Address - Street 1:3304 MASONIC DR STE 4001
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-4255
Practice Address - Country:US
Practice Address - Phone:318-443-7222
Practice Address - Fax:318-443-7641
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA304365207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program