Individual
GERALD E STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8786 GOODWOOD BLVD, STE. 106, BATON ROUGE, LA 70806-7917
(225) 924-0244
(225) 924-0340
Mailing address
8786 GOODWOOD BLVD, STE. 106, BATON ROUGE, LA 70806-7917
(225) 924-0244
(225) 924-0340
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD016009
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1338591
—
LA
Enumeration date
11/22/2006
Last updated
07/08/2007
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