# LAKE CHARLES MEDICAL & SURGICAL CLINIC

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

## Provider details

- **NPI number:** 1982861407
- **Authorized official:** KRIS HICKINGBOTTOM (CEO)
- **Authorized official phone:** (337) 433-8400

## Contact information

- **Practice address:** 4320 LAKE ST, LAKE CHARLES, LA 70605-4310
- **Practice address phone:** (337) 433-8400
- **Mailing address:** 501 S RYAN ST, LAKE CHARLES, LA 70601-5724

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/21/2008
- **Last updated:** 05/21/2008