Individual
BRAD BLAINE RODRIGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Mailing address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
201552
LA
208000000X
Pediatrics Physician
201552
LA
208M00000X
Hospitalist Physician
201552
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08455261
—
MS
05
—
1073865
—
LA
Enumeration date
08/01/2007
Last updated
06/04/2021
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