Provider Demographics
NPI:1205925070
Name:SYLVEST, RONALD D (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:D
Last Name:SYLVEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7414 PICARDY
Mailing Address - Street 2:STE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808
Mailing Address - Country:US
Mailing Address - Phone:225-769-6595
Mailing Address - Fax:225-769-5064
Practice Address - Street 1:7414 PICARDY
Practice Address - Street 2:STE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-769-6595
Practice Address - Fax:225-769-5064
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.015745207XX0005X
LAMD015745207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1360511Medicaid
LA0733320001Medicare NSC
51591Medicare PIN
LA51591Medicare ID - Type Unspecified
LA1360511Medicaid