# OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Our Lady of the Lake Hospital Inc Pediatric Pulmonary Clinic Sleep Lab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235263724
- **Authorized official:** DR. DAVID E THOMAS M.D. (PHYSICIAN)
- **Authorized official phone:** (225) 765-3456

## Contact information

- **Practice address:** 8415 GOODWOOD BLVD, SUITE 105, BATON ROUGE, LA 70806-7851
- **Practice address phone:** (225) 765-4361
- **Practice address fax:** (225) 765-4062
- **Mailing address:** 7777 HENNESSY BLVD, PLAZE 1 STE 406, BATON ROUGE, LA 70808-4300
- **Mailing address phone:** (225) 765-3456
- **Mailing address fax:** (225) 765-1899

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0214X | Pediatric Pulmonology Physician | — | NULL | Yes |
| 2080P0214X | Pediatric Pulmonology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 08/22/2020