Provider Demographics
NPI:1104827112
Name:NOGUCHI, BARBARA ANN (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:NOGUCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10202 JEFFERSON HWY
Mailing Address - Street 2:BLDG D
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3182
Mailing Address - Country:US
Mailing Address - Phone:225-768-8833
Mailing Address - Fax:225-769-4839
Practice Address - Street 1:10202 JEFFERSON HWY
Practice Address - Street 2:BLDG D
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3182
Practice Address - Country:US
Practice Address - Phone:225-768-8833
Practice Address - Fax:225-769-4839
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021479207W00000X
MS18724207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1659720Medicaid
G03658Medicare UPIN
LA1659720Medicaid