Provider Demographics
NPI:1992986715
Name:RED STICK PEDIATRICS
Entity type:Organization
Organization Name:RED STICK PEDIATRICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILBUN-MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-926-4400
Mailing Address - Street 1:888 TARA BLVD
Mailing Address - Street 2:STE F
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-8401
Mailing Address - Country:US
Mailing Address - Phone:225-273-5995
Mailing Address - Fax:225-273-7475
Practice Address - Street 1:888 TARA BLVD
Practice Address - Street 2:STE F
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-8401
Practice Address - Country:US
Practice Address - Phone:225-273-5995
Practice Address - Fax:225-273-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019542208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty