Provider Demographics
NPI:1588709372
Name:STAGE, ROSEMARY B (MD)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:B
Last Name:STAGE
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:P O BOX 3185
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71210-3185
Mailing Address - Country:US
Mailing Address - Phone:318-812-1761
Mailing Address - Fax:318-812-1755
Practice Address - Street 1:101 CATALPA STREET
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7418
Practice Address - Country:US
Practice Address - Phone:318-812-1761
Practice Address - Fax:318-812-1755
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA013331207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1333174Medicaid
LA1333174Medicaid
LA55987CM62Medicare PIN
LAB65947Medicare UPIN