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Organization
PATHOLOGY GROUP OF LOUISIANA, A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
PATHOLOGY GROUP OF LOUISIANA, A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNA M DIETEL (CREDENTIALING SPECIALIST)
(225) 706-0513
Entity
Organization
Contact information
Practice address
5339 O'DONOVAN DRIVE, BATON ROUGE, LA 70808
(225) 766-4999
(225) 763-5870
Mailing address
PO BOX 84030, BATON ROUGE, LA 70884-4030
(225) 766-4999
(225) 763-5870
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
—
NULL
207ZB0001X
Blood Banking & Transfusion Medicine Physician
—
—
207ZC0500X
Cytopathology Physician
—
NULL
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
NULL
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
NULL
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZI0100X
Immunopathology Physician
—
NULL
207ZI0100X
Immunopathology Physician
—
—
207ZM0300X
Medical Microbiology Physician
—
NULL
207ZM0300X
Medical Microbiology Physician
—
—
207ZN0500X
Neuropathology Physician
—
NULL
207ZN0500X
Neuropathology Physician
—
—
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
—
NULL
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
207ZP0213X
Pediatric Pathology Physician
—
NULL
207ZP0213X
Pediatric Pathology Physician
—
—
Other
Enumeration date
02/28/2007
Last updated
04/27/2020
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