Individual
DR. JAKE TRAHAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10101 PARK ROWE AVE STE 200, BATON ROUGE, LA 70810-1685
(225) 769-2200
(225) 768-2185
Mailing address
10101 PARK ROWE AVE STE 200, BATON ROUGE, LA 70810-1685
(225) 769-2200
(225) 768-2185
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
54922
TN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
311176
LA
207LP2900X
Pain Medicine (Anesthesiology) Physician
54922
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311176
LICENSE
LA
Enumeration date
04/13/2015
Last updated
06/12/2020
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