Individual
KEARON L ARBUTHNOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9143 CROSSCREEK AVE, BATON ROUGE, LA 70810-6969
(225) 610-5630
Mailing address
9143 CROSSCREEK AVE, BATON ROUGE, LA 70810-6969
(225) 610-5630
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
010126901
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
850526897
MEDICARE
LA
05
—
850526897
—
LA
Enumeration date
08/16/2022
Last updated
09/09/2022
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