Gerald E Stack, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD016009 Issued in LA

Practice address

8786 Goodwood Blvd
Ste. 106
Baton Rouge, LA 70806-7917

Phone

(225) 924-0244

Fax

(225) 924-0340

NPI assigned

Nov 22, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861567950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8786 GOODWOOD BLVD",
            "address_2": "STE. 106",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067917",
            "telephone_number": "225-924-0244",
            "fax_number": "225-924-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8786 GOODWOOD BLVD",
            "address_2": "STE. 106",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067917",
            "telephone_number": "225-924-0244",
            "fax_number": "225-924-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "GERALD",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "MD016009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1338591",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne Schupbach St.Cyr, R.T.
• Mihnlan Diane St.Cyr
• Luke St.Romain, EMT-B
• Timothy John St.Romain, DDS
• Duston K Stacia, PHARMD.
• Stacy D Jones Medical Group LLC
• Angela C Stafford, LOTR
• Carolyn Claire Adams Stafford, M.O.T.R.
• Darleshia Nichelle Stafford
• Eva Marina Stafford, NP

• Specialist in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.