Provider Demographics
NPI:1689751224
Name:LOUISIANA NEUROLOGIC CONSULTANTS, INC.
Entity Type:Organization
Organization Name:LOUISIANA NEUROLOGIC CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-769-7200
Mailing Address - Street 1:8338 SUMMA AVE
Mailing Address - Street 2:STE 500
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3669
Mailing Address - Country:US
Mailing Address - Phone:225-769-7200
Mailing Address - Fax:225-767-2437
Practice Address - Street 1:8338 SUMMA AVE
Practice Address - Street 2:STE # 500
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3669
Practice Address - Country:US
Practice Address - Phone:225-769-7200
Practice Address - Fax:225-767-2437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA072272084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1944378Medicaid
LA5D225Medicare ID - Type Unspecified