# BATON ROUGE SPORTS MEDICINE CLINIC, LLC

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

## Provider details

- **NPI number:** 1609002849
- **Authorized official:** ROBERT W DUGAS M.D. (SOLE MEMBER)
- **Authorized official phone:** (225) 216-3047

## Contact information

- **Practice address:** 720 CONNELLS PARK LN, BATON ROUGE, LA 70806-6522
- **Practice address phone:** (225) 216-3047
- **Practice address fax:** (225) 928-7054
- **Mailing address:** 720 CONNELLS PARK LN, BATON ROUGE, LA 70806-6522
- **Mailing address phone:** (225) 216-3047
- **Mailing address fax:** (225) 928-7054

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 17260 | LA | Yes |

## Other

- **Enumeration date:** 06/02/2009
- **Last updated:** 06/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1457281 | — | LA |