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Organization
UROLOGY SPECIALTY AND SURGERY CENTER OF SOUTHWEST LOUISIANA
Active
Organization
UROLOGY SPECIALTY AND SURGERY CENTER OF SOUTHWEST LOUISIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH S VERHEECK M.D. (MEDICAL DIRECTOR)
(337) 439-8857
Entity
Organization
Contact information
Practice address
234 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5960
(337) 439-8857
(337) 433-1159
Mailing address
234 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5960
(337) 439-8857
(337) 433-1159
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
42
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1390429
—
LA
01
—
2097C
BLUE CROSS BLUE SHIELD
LA
01
—
490001185
RAILROAD MEDICARE
LA
Enumeration date
11/14/2005
Last updated
07/08/2010
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