# LSUHSC FAMILY PRACTICE CENTER @ LCMH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LSUHSC Family Practice Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073514493
- **Authorized official:** DAWN JOHNSON-HATCHER (CFO)
- **Authorized official phone:** (337) 494-2094

## Contact information

- **Practice address:** 1525 OAK PARK BLVD, LAKE CHARLES, LA 70601-8849
- **Practice address phone:** (337) 494-6767
- **Practice address fax:** (337) 494-6750
- **Mailing address:** PO BOX 123453, DEPT 3453, DALLAS, TX 75312-0001
- **Mailing address phone:** (337) 494-2921
- **Mailing address fax:** (337) 494-6523

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/09/2005
- **Last updated:** 12/04/2023