Organization
ST. ELIZABETH-MARY BIRD PERKINS CANCER CENTER, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB KRAFT (DECISION SUPPORT MANAGER)
(225) 215-1281
Entity
Organization
Contact information
Practice address
1104 W HIGHWAY 30, GONZALES, LA 70737-5003
(225) 215-1223
(225) 766-0218
Mailing address
5215 ESSEN LN STE 200, BATON ROUGE, LA 70809-3543
(225) 215-1281
(225) 215-1380
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
—
—
2085R0001X
Radiation Oncology Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0203X
Therapeutic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1369306
—
LA
Enumeration date
02/06/2008
Last updated
12/18/2025
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