Organization
LAKE CHARLES MEDICAL SERVICES, INC
Active
Other names
J. William Groves, Jr., M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID B USHER FACHE (V.P. OF BUSINESS DEVELOPMENT)
(337) 494-3202
Entity
Organization
Contact information
Practice address
1890 W GAUTHIER RD STE 130, LAKE CHARLES, LA 70605-7179
(337) 480-5530
(337) 480-5531
Mailing address
1890 W GAUTHIER RD STE 130, LAKE CHARLES, LA 70605-7179
(337) 480-5530
(337) 480-5531
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OCCUPATIONAL LICENSE
19506
LA
Enumeration date
06/27/2007
Last updated
08/22/2020
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