# LAKE CHARLES MEDICAL SERVICES ORTHOPEDICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LAKE CHARLES MEDICAL SERVICES INC
- **Other names:** D DREZ MD AND S HOFER DO
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639218407
- **Legal business name:** LAKE CHARLES MEDICAL SERVICES INC
- **Authorized official:** MR. DAVID B USHER FACHE (SR. V.P. BUSINESS DEVELOPMENT)
- **Authorized official phone:** (337) 494-3200

## Contact information

- **Practice address:** 1717 OAK PARK BLVD, LAKE CHARLES, LA 70601-8991
- **Practice address phone:** (337) 494-4900
- **Practice address fax:** (337) 494-4936
- **Mailing address:** 1717 OAK PARK BLVD, LAKE CHARLES, LA 70601-8991
- **Mailing address phone:** (337) 494-4900
- **Mailing address fax:** (337) 494-4936

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/06/2007
- **Last updated:** 06/13/2008

## 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 |