Organization
PATHOLOGY GROUP OF LOUISIANA, A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNA M BARKER (CREDENTIALING)
(225) 706-0513
Entity
Organization
Contact information
Practice address
5339 ODONOVAN DR, BATON ROUGE, LA 70808-4388
(225) 766-4999
(225) 763-5870
Mailing address
5339 ODONOVAN DR, BATON ROUGE, LA 70808-4388
(225) 766-4999
(225) 764-4702
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184781
—
LA
01
—
18336
MEDICARE INDEPENDANT LAB
LA
Enumeration date
11/04/2008
Last updated
06/25/2024
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