Provider Demographics
NPI:1730683525
Name:GROVES, LAUREN (DO)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:GROVES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:985-730-6970
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:420 AVENUE F
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3634
Practice Address - Country:US
Practice Address - Phone:985-730-6970
Practice Address - Fax:985-730-6363
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA3295312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program