Organization
LAKE CHARLES MEDICAL SERVICES FAMILY PRACTICE ASSOCIATES, LLC
Active
Parent organization
LAKE CHARLES MEDICAL SERVICES, INC
Other names
Family Medicine Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE CHARLES MEDICAL SERVICES, INC
Authorized official
DAWN JOHNSON-HATCHER (CFO)
(337) 494-2094
Entity
Organization
Contact information
Practice address
2750 ASTER ST, LAKE CHARLES, LA 70601-8824
(337) 480-8900
(337) 480-8901
Mailing address
PO BOX 122539 DEPT 2539, DALLAS, TX 75312-2539
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700011544
OCCUPATIONAL LICENSE/MOUT
LA
05
—
1048429
—
LA
Enumeration date
11/21/2007
Last updated
12/04/2023
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