Organization
CENTER FOR ORTHOPAEDICS AND SPINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WALLACE NOBLE MD (MANAGER MEMBER)
(337) 721-7242
Entity
Organization
Contact information
Practice address
1727 IMPERIAL BLVD BLDG 1B, LAKE CHARLES, LA 70605-5392
(337) 721-7236
Mailing address
1747 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
Other
Enumeration date
04/29/2020
Last updated
05/07/2020
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