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Contact Information

STEPHEN W ETHEREDGE, MD
8080 BLUEBONNET BLVD STE 1000
BATON ROUGE, LA70810-7827
 Phone: 225-924-2424
 Fax: 225-408-7980
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine - Sports Medicine

207QS0010X 08 Physician/Family Practice
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for STEPHEN W ETHEREDGE · (Male)

NPI # 1629212972
Status Active
Credentials MD
Entity Individual
Enumeration date 04/29/2009
Last updated 08/26/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # TRN 13458
  • LA License # MD.205635
Hospital affiliation(s)
  • MERCY REGIONAL MEDICAL CENTER - (Acute Care)
    800 E MAIN
    VILLE PLATTE, LA 70586
  • SURGICAL SPECIALTY CENTER OF BATON ROUGE - (Acute Care)
    8080 BLUEBONNET BLVD
    BATON ROUGE, LA 70810
  • WOMAN'S HOSPITAL - (Acute Care)
    100 WOMAN'S WAY
    BATON ROUGE, LA 70817
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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