Individual
JYOTI S PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10101 PARK ROWE AVE, SUITE 200, BATON ROUGE, LA 70810-1686
(225) 769-2200
(225) 768-2185
Mailing address
PO BOX 98509, BATON ROUGE, LA 70884-9509
(225) 769-2200
(225) 768-2185
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
200029
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1621803
—
LA
Enumeration date
10/20/2005
Last updated
03/28/2008
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