Organization
THE MEDICAL SPA OF BATON ROUGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENYATTA DAYATRA SHAMLIN M.D. (CO-OWNER)
(225) 216-7885
Entity
Organization
Contact information
Practice address
7150 JEFFERSON HWY, SUITE 530, BATON ROUGE, LA 70806-8128
(225) 216-7885
Mailing address
7150 JEFFERSON HWY, SUITE 530, BATON ROUGE, LA 70806-8128
(225) 216-7885
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
202129
LA
207R00000X
Internal Medicine Physician
025910
LA
207R00000X
Internal Medicine Physician
Primary
025911
LA
Other
Enumeration date
03/04/2010
Last updated
03/04/2010
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