Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MALLORY BOURG
ActiveMALLORY BOURG is a Physician Assistant healthcare provider located in BATON ROUGE, Louisiana. NPI 1164816831 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · BATON ROUGE, LA
Registration Details
- NPI Number
- 1164816831
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 20, 2015 (11.39265706288 yrs)
- Last Updated
- Sep 29, 2023
- License
-
200789 (LA)
Practice Information
- Address
-
7777 HENNESSY BLVDSUITE 701BATON ROUGE, LA, 708084300Browse LA providers · Browse ZIP 70808
- Phone
- 2257655864
- Fax
- 2257652013
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in BATON ROUGE, LA
| Name | Credential | NPI |
|---|---|---|
| DONNA H FOSTER | PA | 1093717266 |
| MR. JOHN BRETT WILLIAMSON | PA | 1366448623 |
| MR. JASON G GHAHRAMANI | PAC | 1396732400 |
| MR. MARC E PITRE | PAC | 1154318269 |
| CHRISTA RHODES HENDERSON | PA-C | 1942270517 |
| TERRI L. ROSS | PA | 1891762167 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.