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Organization
MEMORIAL MEDICAL GROUP, LLC
Active
Organization
MEMORIAL MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH THERESA LEBLANC (BUSINESS OFFICE ANALYST /PROGRAMMER)
(337) 494-2577
Entity
Organization
Contact information
Practice address
1701 OAK PARK BLVD, LAKE CHARLES, LA 70601-8911
(337) 494-3000
Mailing address
1701 OAK PARK BLVD, LAKE CHARLES, LA 70601-8911
(337) 494-3000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/05/2019
Last updated
06/11/2019
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