# GERALD E. STACK M.D., APMC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356614218
- **Authorized official:** TAMMY BETZ (PRACTICE MANAGER)
- **Authorized official phone:** (225) 924-0244

## Contact information

- **Practice address:** 8786 GOODWOOD BLVD, SUITE 106, BATON ROUGE, LA 70806-7917
- **Practice address phone:** (225) 924-0244
- **Practice address fax:** (225) 924-0340
- **Mailing address:** 8786 GOODWOOD BLVD, SUITE 106, BATON ROUGE, LA 70806-7917

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 016009 | LA | Yes |

## Other

- **Enumeration date:** 02/22/2012
- **Last updated:** 02/22/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1338591 | — | LA |