Organization
LAFAYETTE SURGICAL HOSPITAL, LLC
Active
Other names
Lafayette Surgical Specialty Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
1025 KALISTE SALOOM RD, LAFAYETTE, LA 70508-4963
(337) 237-3424
Mailing address
1101 KALISTE SALOOM RD, LAFAYETTE, LA 70508-5705
(337) 769-4100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
524
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1703036
—
LA
01
—
60695
BLUE CROSS
LA
Enumeration date
10/30/2014
Last updated
02/08/2023
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