Provider Demographics
NPI:1831496793
Name:BATON ROUGE CLINIC, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:BATON ROUGE CLINIC, A MEDICAL CORPORATION
Other - Org Name:BATON ROUGE CLINIC URGENT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO / ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:H
Authorized Official - Last Name:SILVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-246-9301
Mailing Address - Street 1:7373 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4326
Mailing Address - Country:US
Mailing Address - Phone:225-769-4044
Mailing Address - Fax:
Practice Address - Street 1:7479 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4328
Practice Address - Country:US
Practice Address - Phone:225-769-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BATON ROUGE CLINIC, A MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-11
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1003310Medicaid