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Organization
LAKE AREA PHYSICIAN SERVICES LLC
Active
Organization
LAKE AREA PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBBIE E BREWER MBA (DIRECTOR OF PROVIDER ENROLLMENT)
(877) 892-9813
Entity
Organization
Contact information
Practice address
4200 NELSON RD, LAKE CHARLES, LA 70605-4118
(337) 474-6370
(337) 475-4143
Mailing address
4200 NELSON RD, LAKE CHARLES, LA 70605-4118
(377) 474-6370
(337) 475-4143
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
NULL
207VM0101X
Maternal & Fetal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
NULL
2080P0202X
Pediatric Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1442682
—
LA
Enumeration date
03/23/2006
Last updated
09/23/2010
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