| Raynando L. Banks, M.d., Inc. | |
|
3905 Convention St Baton Rouge LA 70806-3806 | |
| (225) 387-7858 | |
| (225) 381-6980 |
| Full Name | Raynando L. Banks, M.d., Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3905 Convention St, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Raynando L Banks (OWNER) |
| Authorized Official Contact | 2253877858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Raynando L. Banks, M.d., Inc. 3905 Convention St Baton Rouge LA 70806-3806 Ph: (225) 387-7858 | Raynando L. Banks, M.d., Inc. 3905 Convention St Baton Rouge LA 70806-3806 Ph: (225) 387-7858 |
| NPI Number | 1457667925 |
|---|---|
| Provider Enumeration Date | 08/23/2010 |
| Last Update Date | 08/23/2010 |
| Medicare PECOS PAC ID | 4385830736 |
|---|---|
| Medicare Enrollment ID | O20101124000179 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457667925 | NPI | - | NPPES |
| 1924245 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Raynando L Banks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952339533 PECOS PAC ID: 3476562190 Enrollment ID: I20101124000254 |
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