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Individual

JOHN E NYBOER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
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
208100000X
Physical Medicine & Rehabilitation Physician
Primary
10309R
LA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
10309R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1986356
LA
Enumeration date
10/21/2005
Last updated
04/01/2014
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