Provider Demographics
NPI:1902873516
Name:CALEGAN, GERALD JOSEPH II (MD)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:JOSEPH
Last Name:CALEGAN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GERALD
Other - Middle Name:J
Other - Last Name:CALEGAN
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 98509
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70884-9509
Mailing Address - Country:US
Mailing Address - Phone:225-769-2200
Mailing Address - Fax:225-768-2185
Practice Address - Street 1:10101 PARK ROWE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810
Practice Address - Country:US
Practice Address - Phone:225-769-2200
Practice Address - Fax:225-768-2185
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24995207R00000X
LA2008402084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051516518OtherBLUE CROSS BLUE SHIELD
LA1529001Medicaid
LA1529001Medicaid
AL051553794Medicare ID - Type Unspecified
LA4K1127545Medicare ID - Type Unspecified