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Organization
GERALD E. STACK M.D., APMC
Active
Organization
GERALD E. STACK M.D., APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY BETZ (PRACTICE MANAGER)
(225) 924-0244
Entity
Organization
Contact information
Practice address
8786 GOODWOOD BLVD, SUITE 106, BATON ROUGE, LA 70806-7917
(225) 924-0244
(225) 924-0340
Mailing address
8786 GOODWOOD BLVD, SUITE 106, BATON ROUGE, LA 70806-7917
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
016009
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1338591
—
LA
Enumeration date
02/22/2012
Last updated
02/22/2012
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