Organization
MARY BIRD PERKINS CANCER CENTER
Active
Other names
Mary Bird Perkins Cancer Center Medicaid Group
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL R. NOWACKI (CFO)
(225) 215-1223
Entity
Organization
Contact information
Practice address
4950 ESSEN LN, BATON ROUGE, LA 70809-3738
(225) 767-0847
(225) 766-0218
Mailing address
4950 ESSEN LN, BATON ROUGE, LA 70809-3738
(225) 767-0847
(225) 766-0218
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
12/18/2008
Last updated
11/17/2023
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