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Organization
LAKE CHARLES MEDICAL SERVICES ORTHOPEDICS LLC
Active
Organization
LAKE CHARLES MEDICAL SERVICES ORTHOPEDICS LLC
Active
Parent organization
LAKE CHARLES MEDICAL SERVICES INC
Other names
D DREZ MD AND S HOFER DO
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE CHARLES MEDICAL SERVICES INC
Authorized official
MR. DAVID B USHER FACHE (SR. V.P. BUSINESS DEVELOPMENT)
(337) 494-3200
Entity
Organization
Contact information
Practice address
1717 OAK PARK BLVD, LAKE CHARLES, LA 70601-8991
(337) 494-4900
(337) 494-4936
Mailing address
1717 OAK PARK BLVD, LAKE CHARLES, LA 70601-8991
(337) 494-4900
(337) 494-4936
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-00010827
OCCUPATIONAL LICENSE
LA
05
—
1030422
—
LA
01
—
DF6777
RAILROAD MCR
LA
01
—
NH6097
BCBS
LA
Enumeration date
02/06/2007
Last updated
06/13/2008
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