Organization
LAKEVIEW TRAUMA AND CRITICAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN REBOK (GROUP VP/AO)
(615) 372-5004
Entity
Organization
Contact information
Practice address
101 JUDGE TANNER BLVD STE 300, COVINGTON, LA 70433-7506
(985) 867-3800
Mailing address
PO BOX 748630, ATLANTA, GA 30374-8630
(615) 373-7600
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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