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Organization

LAFOURCHE PHYSICIAN SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISHA C FALK (VP OF CONTRACTING)
(800) 893-9698
Entity
Organization

Contact information

Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4847
(800) 893-9698
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(337) 354-1153

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2317091
LA
Enumeration date
09/12/2012
Last updated
01/13/2016
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