Provider Demographics
NPI:1386083178
Name:WOMAN'S GYNECOLOGIC ONCOLOGY
Entity type:Organization
Organization Name:WOMAN'S GYNECOLOGIC ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-924-8310
Mailing Address - Street 1:500 RUE DE LA VIE ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-5127
Mailing Address - Country:US
Mailing Address - Phone:225-216-3006
Mailing Address - Fax:225-216-1081
Practice Address - Street 1:500 RUE DE LA VIE ST
Practice Address - Street 2:SUITE 311
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-5127
Practice Address - Country:US
Practice Address - Phone:225-216-3006
Practice Address - Fax:225-216-1081
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMANS HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty