Organization
BREAST SPECIALTY OF BATON ROUGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W HAILEY M.D. (CEO)
(225) 216-1118
Entity
Organization
Contact information
Practice address
9000 AIRLINE HWY, SUITE 250, BATON ROUGE, LA 70815-4114
(225) 216-1118
(225) 216-1119
Mailing address
9000 AIRLINE HWY, SUITE 250, BATON ROUGE, LA 70815-4114
(225) 216-1118
(225) 216-1119
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14794R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1122866
—
LA
Enumeration date
03/14/2007
Last updated
05/24/2011
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