Organization
CENTER FOR ORTHOPAEDICS AND SPINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WALLACE NOBLE MD (MANAGER MEMBER)
(337) 721-7236
Entity
Organization
Contact information
Practice address
4150 NELSON RD STE C11, LAKE CHARLES, LA 70605-4133
(337) 312-8617
(337) 721-2939
Mailing address
1747 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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