# BATON ROUGE GENERAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BRGP Family Medicine-Port Allen, BATON ROUGE GENERAL PHYSICIANS FAMILY MEDICINE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407284540
- **Authorized official:** KENDALL JOHNSON (C.F.O.)
- **Authorized official phone:** (225) 237-1645

## Contact information

- **Practice address:** 610 N JEFFERSON AVE, PORT ALLEN, LA 70767-2414
- **Practice address phone:** (225) 267-6626
- **Practice address fax:** (225) 267-5993
- **Mailing address:** 8490 PICARDY AVE, BLDG 200, BATON ROUGE, LA 70809-3731
- **Mailing address phone:** (225) 237-1754
- **Mailing address fax:** (225) 237-1722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD019597 | LA | Yes |

## Other

- **Enumeration date:** 10/29/2013
- **Last updated:** 12/26/2018