Organization
BELLE CHASSE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA C FALK (VP OF CONTRACTING)
(337) 609-1221
Entity
Organization
Contact information
Practice address
2500 BELLE CHASSE HWY, TERRYTOWN, LA 70056-7127
(800) 893-9698
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2354965
—
LA
01
—
552945
MEDICARE OF LOUISIANA
LA
Enumeration date
01/27/2014
Last updated
09/12/2023
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