Provider Demographics
NPI:1689835241
Name:QUIN, NATHAN GARY (MD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:GARY
Last Name:QUIN
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 1:5000 HENNESSY BLVD
Mailing Address - Street 2:HOSPITAL MEDICINE SVCS, 5000 HENNESSY BLVD
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4375
Mailing Address - Country:US
Mailing Address - Phone:225-765-4050
Mailing Address - Fax:225-765-4036
Practice Address - Street 1:5000 HENNESSY BLVD
Practice Address - Street 2:HOSPITAL MEDICINE SVCS, 5000 HENNESSY BLVD
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4375
Practice Address - Country:US
Practice Address - Phone:225-765-4050
Practice Address - Fax:225-765-4036
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA203367207R00000X
LAMD.203367208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1101052Medicaid
4Q327CF34OtherMEDICARE
MS04327521Medicaid
LA1101052Medicaid