Provider Demographics
NPI:1457735250
Name:SOUTHERN REGIONAL WOUND CARE CONSULTANTS, LLC
Entity type:Organization
Organization Name:SOUTHERN REGIONAL WOUND CARE CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-580-6416
Mailing Address - Street 1:301 MAIN ST
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70801-1919
Mailing Address - Country:US
Mailing Address - Phone:337-580-6416
Mailing Address - Fax:
Practice Address - Street 1:301 MAIN ST
Practice Address - Street 2:SUITE 2200
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70801-1919
Practice Address - Country:US
Practice Address - Phone:337-580-6416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty