Provider Demographics
NPI:1154876670
Name:ORTHOBR LLC
Entity type:Organization
Organization Name:ORTHOBR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:SYLVEST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-769-6595
Mailing Address - Street 1:7414 PICARDY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4696
Mailing Address - Country:US
Mailing Address - Phone:225-769-6595
Mailing Address - Fax:225-769-5064
Practice Address - Street 1:7414 PICARDY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4696
Practice Address - Country:US
Practice Address - Phone:225-769-6595
Practice Address - Fax:225-769-5064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAMD015745OtherORTHOPEDIC PHYSICIAN