Basic Information
| Provider Information | |||||||||
| NPI: | 1659360964 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HANSBROUGH, PETERS, TRAXLER & SCALLAN MEDICAL ASSOCIATION, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8080 BLUEBONNET BLVD | ||||||||
| Address2: | STE. 2121 | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708107827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257677200 | ||||||||
| FaxNumber: | 2257677386 | ||||||||
| Practice Location | |||||||||
| Address1: | 8080 BLUEBONNET BLVD | ||||||||
| Address2: | STE. 2121 | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708107827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257677200 | ||||||||
| FaxNumber: | 2257677386 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2005 | ||||||||
| LastUpdateDate: | 02/08/2011 | ||||||||
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| AuthorizedOfficialLastName: | HIDALGO | ||||||||
| AuthorizedOfficialFirstName: | DELLA | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING DEPT | ||||||||
| AuthorizedOfficialTelephone: | 2254086729 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.