Organization
LAKE PROFESSIONALS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLASS H PERRET (CEO)
(337) 233-1114
Entity
Organization
Contact information
Practice address
501 W SAINT MARY BLVD STE 210, LAFAYETTE, LA 70506-4699
(337) 233-1114
Mailing address
PO BOX 53388, LAFAYETTE, LA 70505-3388
(337) 233-1114
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/03/2019
Last updated
04/25/2023
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