# LAKE AREA PHYSICIAN SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770543076
- **Authorized official:** MS. DEBBIE E BREWER MBA (DIRECTOR OF PROVIDER ENROLLMENT)
- **Authorized official phone:** (877) 892-9813

## Contact information

- **Practice address:** 4200 NELSON RD, LAKE CHARLES, LA 70605-4118
- **Practice address phone:** (337) 474-6370
- **Practice address fax:** (337) 475-4143
- **Mailing address:** 4200 NELSON RD, LAKE CHARLES, LA 70605-4118
- **Mailing address phone:** (377) 474-6370
- **Mailing address fax:** (337) 475-4143

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 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

- **Enumeration date:** 03/23/2006
- **Last updated:** 09/23/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1442682 | — | LA |