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Organization

LAKESIDE MEDICAL WELLNESS CLINIC

Active
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Organization

LAKESIDE MEDICAL WELLNESS CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GEORGE E SMITH MD (OWNER)
(337) 527-9529
Entity
Organization

Contact information

Practice address
110 E DARBONNE ST STE B, SULPHUR, LA 70663-4958
(337) 527-9529
(337) 527-5049
Mailing address
110 E DARBONNE ST STE B, SULPHUR, LA 70663-4958
(337) 527-9529
(337) 527-5049

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
LA

Other

Enumeration date
01/16/2008
Last updated
07/21/2022
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  • Eligibility checks
  • EDI platform