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Organization
OUR LADY OF THE LAKE PHYSICIAN GROUP, LLC
Active
Organization
OUR LADY OF THE LAKE PHYSICIAN GROUP, LLC
Active
Other names
Our Lady of the Lake Physician Group-Riverside
Organization subpart
No
Provider details
NPI number
Authorized official
JAMY A RICHARD (VP FINANCE)
(225) 526-0121
Entity
Organization
Contact information
Practice address
18740 HIGHWAY 22, MAUREPAS, LA 70449-3018
(225) 698-3435
(225) 698-6446
Mailing address
18740 HIGHWAY 22, MAUREPAS, LA 70449-3018
(225) 698-3435
(225) 698-6446
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
NULL
261QR1300X
Rural Health Clinic/Center
Primary
115
LA
Other
Enumeration date
07/08/2006
Last updated
03/01/2017
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