# LAKE CHARLES MEDICAL SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** J. William Groves, Jr., M.D.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548467236
- **Authorized official:** DAVID B USHER FACHE (V.P. OF BUSINESS DEVELOPMENT)
- **Authorized official phone:** (337) 494-3202

## Contact information

- **Practice address:** 1890 W GAUTHIER RD STE 130, LAKE CHARLES, LA 70605-7179
- **Practice address phone:** (337) 480-5530
- **Practice address fax:** (337) 480-5531
- **Mailing address:** 1890 W GAUTHIER RD STE 130, LAKE CHARLES, LA 70605-7179
- **Mailing address phone:** (337) 480-5530
- **Mailing address fax:** (337) 480-5531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/27/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | OCCUPATIONAL LICENSE | 19506 | LA |