Individual
DR. CECIL NOEL BANKSTON JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4841 WOODLAKE DR, BATON ROUGE, LA 70817-1833
(225) 753-7917
Mailing address
4841 WOODLAKE DR, BATON ROUGE, LA 70817-1833
(225) 753-7917
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
011675
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1189596
—
LA
Enumeration date
07/11/2005
Last updated
07/08/2007
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