Organization
CENTER FOR ORTHOPAEDICS AND SPINE, LLC
Active
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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