Dewaard, John

Dewaard, John is an individual health care provider with primary practice located at 10310 The Grove Blvd , Baton Rouge LA 70836-6455. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Dewaard, John can be contacted via phone (225) 388-6630.

Contact Information

Primary practice address
10310 The Grove Blvd Baton Rouge LA 70836-6455
Phone: (225) 388-6630
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 347471 Louisiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101028098 Michigan

Profile Details

NPI number 1629647805
LBN Legal business name Dewaard, John
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2021
Last updated Oct 17th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629647805 NPPES
Nebraska MEDICAID 470553011-00

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