Provider Demographics
NPI:1982732343
Name:PATHOLOGY ASSOCIATES OF SOUTHERN LOUISIANA
Entity type:Organization
Organization Name:PATHOLOGY ASSOCIATES OF SOUTHERN LOUISIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:EMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-766-4999
Mailing Address - Street 1:PO BOX 84260
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70884-4260
Mailing Address - Country:US
Mailing Address - Phone:225-766-4999
Mailing Address - Fax:225-763-5870
Practice Address - Street 1:5339 O'DONOVAN DRIVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-766-4999
Practice Address - Fax:225-763-5870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1796964Medicaid
LA5B250Medicare ID - Type Unspecified