Individual
DR. JOHN LIEBERT COLLIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000 OPELOUSAS ST, LAKE CHARLES, LA 70601-2641
(337) 439-9983
(337) 437-9460
Mailing address
3203 CYPRIEN LN, LAKE CHARLES, LA 70605-2254
(337) 478-6361
(337) 474-0628
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
10207
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1121878
—
LA
Enumeration date
08/22/2005
Last updated
07/28/2008
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