Provider Demographics
NPI:1700923992
Name:DIVERSIFIED PROFESSIONALS, INC.
Entity type:Organization
Organization Name:DIVERSIFIED PROFESSIONALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SIKES
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:225-923-0030
Mailing Address - Street 1:8946 INTERLINE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1913
Mailing Address - Country:US
Mailing Address - Phone:225-923-0030
Mailing Address - Fax:225-923-0060
Practice Address - Street 1:8946 INTERLINE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1913
Practice Address - Country:US
Practice Address - Phone:225-923-0030
Practice Address - Fax:225-923-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty