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Organization

SOUTHPARK COMMUNITY HOSPITAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LINDA DEVILLE (CEO)
(337) 769-4080
Entity
Organization

Contact information

Practice address
314 YOUNGSVILLE HWY, LAFAYETTE, LA 70508-4524
(337) 769-4080
Mailing address
314 YOUNGSVILLE HWY, LAFAYETTE, LA 70508-4524
(337) 769-4080

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
204F00000X
Transplant Surgery Physician
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
207L00000X
Anesthesiology Physician
207R00000X
Internal Medicine Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RN0300X
Nephrology Physician
2085R0202X
Diagnostic Radiology Physician
208600000X
Surgery Physician
208800000X
Urology Physician
208D00000X
General Practice Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1729388
LA
01
61343
BLUE CROSS
LA
Enumeration date
01/19/2006
Last updated
09/11/2025
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