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Organization

CENTER FOR ORTHOPAEDICS AND SPINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN WALLACE NOBLE JR. MD (MANAGER MEMBER)
(337) 721-7242
Entity
Organization

Contact information

Practice address
250 BEGLIS PKWY STE 1, SULPHUR, LA 70663-3503
(337) 626-2529
Mailing address
1747 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
(337) 721-7236
(337) 721-7237

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
207T00000X
Neurological Surgery Physician
207X00000X
Orthopaedic Surgery Physician
Primary
208100000X
Physical Medicine & Rehabilitation Physician
2086S0105X
Surgery of the Hand (Surgery) Physician
208VP0014X
Interventional Pain Medicine Physician
213ES0103X
Foot & Ankle Surgery Podiatrist

Other

Enumeration date
11/05/2019
Last updated
02/15/2020
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