# GREAT RIVER ORTHOPEDIC & SPORTS MEDICINE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Orthopedic & Sports Medicine Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770309460
- **Authorized official:** JEFFREY F TRAINA MD (OWNER)
- **Authorized official phone:** (337) 404-4075

## Contact information

- **Practice address:** 801 W BAYOU PINES DR, LAKE CHARLES, LA 70601-7076
- **Practice address phone:** (337) 549-7770
- **Practice address fax:** (337) 595-1040
- **Mailing address:** 1106 PORT ARTHUR TER, LEESVILLE, LA 71446-4643
- **Mailing address phone:** (337) 404-4075
- **Mailing address fax:** (337) 595-1040

## Taxonomy

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

## Other

- **Enumeration date:** 11/26/2024
- **Last updated:** 11/26/2024