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Organization
OUR LADY OF THE LAKE REGIONAL MEDICA
Active
Organization
OUR LADY OF THE LAKE REGIONAL MEDICA
Active
Other names
Our Lady Of The Lake Hospital Inc Pediatric Pulmonary Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA WHITE (DIRECTOR OF BUSINESS SERVICES)
(225) 765-4251
Entity
Organization
Contact information
Practice address
7777 HENNESSY BLVD, PLAZA 1 SUITE 406, BATON ROUGE, LA 70810
(225) 765-3456
(225) 765-1899
Mailing address
8415 GOODWOOD BLVD, SUITE 105, BATON ROUGE, LA 70806
(225) 413-4361
(225) 765-4062
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
—
NULL
2080P0214X
Pediatric Pulmonology Physician
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
05/19/2011
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