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Organization
LAKE CHARLES MEDICAL SERVICES, INC
Active
Organization
LAKE CHARLES MEDICAL SERVICES, INC
Active
Other names
J. William Groves, Jr., M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID B USHER FACHE (V.P. OF BUSINESS DEVELOPMENT)
(337) 494-3202
Entity
Organization
Contact information
Practice address
1890 W GAUTHIER RD STE 130, LAKE CHARLES, LA 70605-7179
(337) 480-5530
(337) 480-5531
Mailing address
1890 W GAUTHIER RD STE 130, LAKE CHARLES, LA 70605-7179
(337) 480-5530
(337) 480-5531
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OCCUPATIONAL LICENSE
19506
LA
Enumeration date
06/27/2007
Last updated
08/22/2020
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