Dr Ian Konrad Kang, MD | |
7777 Hennessy Blvd, Suite 502, Baton Rouge, LA 70808-4300 | |
(225) 765-2054 | |
(225) 765-3342 |
Full Name | Dr Ian Konrad Kang |
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Gender | Male |
Speciality | Pediatrics - Pediatric Gastroenterology |
Location | 7777 Hennessy Blvd, Baton Rouge, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1699856450 | NPI | - | NPPES |
2113461 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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208000000X | Pediatrics | 036110845 (Illinois) | Secondary |
2080P0206X | Pediatrics - Pediatric Gastroenterology | MD.203969 (Louisiana) | Primary |
Entity Name | The Board Of Trustees Of The University Of Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386863819 PECOS PAC ID: 3072422716 Enrollment ID: O20031112000158 |
Entity Name | Osf Multi-specialty Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
Mailing Address | Practice Location Address |
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Dr Ian Konrad Kang, MD 7777 Hennessy Blvd, Suite 502, Baton Rouge, LA 70808-4300 Ph: (225) 765-2054 | Dr Ian Konrad Kang, MD 7777 Hennessy Blvd, Suite 502, Baton Rouge, LA 70808-4300 Ph: (225) 765-2054 |
Manish Gope Raisingani, Pediatrics Medicare: Medicare Enrolled Practice Location: 8200 Constantin Blvd Fl 4, Baton Rouge, LA 70809 Phone: 225-765-5500 Fax: 225-765-1733 | |
Traci T. Lacy, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 7373 Perkins Rd, Baton Rouge, LA 70808 Phone: 225-769-4044 | |
Dr. Michelle L Flechas, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 12525 Perkins Rd, Suite C, Baton Rouge, LA 70810 Phone: 225-769-2003 Fax: 225-767-3055 | |
Dr. Richard Francis Lasseigne Jr., MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8300 Constantin Blvd, Baton Rouge, LA 70809 Phone: 225-374-1410 Fax: 225-374-1616 | |
Dr. Horace Jay Collinsworth, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 8415 Goodwood Blvd, Suite 100, Baton Rouge, LA 70806 Phone: 225-765-5633 Fax: 225-765-5634 | |
Myriam Aracelis Ortiz-de Jesus', MD Pediatrics Medicare: Medicare Enrolled Practice Location: 11424 Sullivan Rd, Suite B1, Baton Rouge, LA 70818 Phone: 225-761-5200 | |
Kelly Elizabeth Ordemann, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8415 Goodwood Blvd Ste 202, Baton Rouge, LA 70806 Phone: 225-765-8013 Fax: 225-765-2033 |