Organization
PEDIATRIC SURGERY OF LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH HANSBROUGH MD (PHYSICIAN)
(225) 769-2295
Entity
Organization
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 212, BATON ROUGE, LA 70808
(225) 769-2295
(225) 769-2297
Mailing address
7777 HENNESSY BLVD, SUITE 212, BATON ROUGE, LA 70808
(225) 769-2295
(225) 769-2297
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1442534
—
LA
Enumeration date
02/06/2007
Last updated
01/16/2014
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