Individual
KYLE JUDE PONTIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8200 CONSTANTIN BLVD FL 1, BATON ROUGE, LA 70809-3481
(225) 765-5500
(225) 374-1670
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5500
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
207988
LA
208000000X
Pediatrics Physician
54631
TN
208000000X
Pediatrics Physician
GETP.200986
LA
2080S0010X
Pediatric Sports Medicine Physician
2020020214
MO
Other
Enumeration date
07/12/2012
Last updated
02/13/2026
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