Organization
OUR LADY OF THE LAKE ASCENSION, LLC
Active
Parent organization
OUR LADY OF THE LAKE ASCENSION COMMUNITY HOSPITAL
Other names
St Elizabeth Physicians Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
OUR LADY OF THE LAKE ASCENSION COMMUNITY HOSPITAL
Authorized official
DR. JOHN F FRAICHE M.D. (PRESIDENT)
(225) 743-2651
Entity
Organization
Contact information
Practice address
2647 S RIVERVIEW BLVD, GONZALES, LA 70737-5021
(225) 647-8511
(225) 644-5213
Mailing address
2647 S. RIVERVIEW BLVD, GONZALES, LA 70737
(225) 647-8511
(225) 644-5213
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
12027R
LA
207RP1001X
Pulmonary Disease Physician
R001375
LA
208600000X
Surgery Physician
Primary
026022
LA
208600000X
Surgery Physician
04796R
LA
208800000X
Urology Physician
024919
LA
Other
Enumeration date
01/26/2009
Last updated
06/03/2009
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