Organization
SURGICAL ANESTHESIA OF BATON ROUGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW R. RIBAUDO (PRESIDENT)
(404) 446-1417
Entity
Organization
Contact information
Practice address
1757 IMPERIAL BOULEVARD, LAKE CHARLES, LA 70605-5362
(855) 706-5542
(706) 650-1034
Mailing address
PO BOX #204298, DALLAS, TX 75320-4298
(855) 706-5542
(706) 650-1034
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1444413
—
LA
Enumeration date
10/17/2005
Last updated
04/05/2016
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