Organization
JEFFERSON DAVIS ANESTHESIA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY CHARLES GRANGER CRNA (PRESIDENT)
(225) 755-4141
Entity
Organization
Contact information
Practice address
13460 COURSEY BLVD, BATON ROUGE, LA 70816-4972
(225) 755-4141
(225) 755-4152
Mailing address
13460 COURSEY BLVD, BATON ROUGE, LA 70816-4972
(225) 755-4141
(225) 755-4152
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN037167
LA
Other
Enumeration date
07/27/2009
Last updated
07/27/2009
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