Organization
OUR LADY OF THE LAKE HOSPITAL INC
Active
Other names
OLOL Comprehensive Chronic Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C DAVIDGE (CEO)
(225) 765-8802
Entity
Organization
Contact information
Practice address
7777 HENNESSY BLVD, PLAZA 1 SUITE 306, BATON ROUGE, LA 70808
(225) 765-4361
(225) 765-4062
Mailing address
8415 GOODWOOD BLVD, SUITE 105, BATON ROUGE, LA 70806
(225) 765-4361
(225) 765-4062
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1150436
—
LA
Enumeration date
02/13/2007
Last updated
08/22/2020
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