Matthew Ivanyisky, PA-C
Physician Assistant in Baton Rouge, LA. Individual provider (NPI-1).
NPI number1871069377
StatusActive
Last updated in NPPESOct 23, 2018
Details
- NPI
- 1871069377
- Entity type
- Individual (NPI-1)
- Name
- Mr. Matthew Ivanyisky
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 23, 2018
- Last updated
- Oct 23, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 310189 | LA | Yes |
Practice location
16777 Medical Center DrBaton Rouge, LA 70816-3254
Phone 225-761-5200
Mailing address
Po Box 471Albany, LA 70711-0471
Phone 225-229-6288
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