Organization
HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH
Active
Other names
LANE REGIONAL MEDICAL CENTER-LANE PEDIATRICS CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK A CORCORAN (CHIEF EXECUTIVE OFFICER)
(225) 658-4303
Entity
Organization
Contact information
Practice address
6110 MAIN ST STE B, ZACHARY, LA 70791-4079
(225) 654-3607
(225) 658-2262
Mailing address
6300 MAIN ST, ZACHARY, LA 70791-4037
(225) 570-2489
(225) 570-2986
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1445126
—
LA
Enumeration date
07/26/2017
Last updated
03/11/2025
Update your record
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