# OUR LADY OF LAKE ASCENSION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ST ELIZABETH PHYSICIANS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306899067
- **Authorized official:** JOHN F. FRAICHE M.D. (PRESIDENT)
- **Authorized official phone:** (225) 647-8511

## Contact information

- **Practice address:** 2647 S ST. ELIZABETH BLVD, SUITE 100, GONZALES, LA 70737-5021
- **Practice address phone:** (225) 647-8511
- **Practice address fax:** (225) 644-5213
- **Mailing address:** 2647 S ST. ELIZABETH BLVD, SUITE 100, GONZALES, LA 70737-5021
- **Mailing address phone:** (225) 647-8511
- **Mailing address fax:** (225) 644-5213

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 013784 | LA | Yes |

## Other

- **Enumeration date:** 05/17/2006
- **Last updated:** 03/04/2015