Organization
LAKE CHARLES MEDICAL SERVICES
Active
Organization
LAKE CHARLES MEDICAL SERVICES
Active
Parent organization
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION
Other names
Neurosurgical Institute of Lake Charles
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION
Authorized official
MR. DAVID BRIAN USHER FACHE (CHIEF OPERATIONS OFFICER)
(337) 494-3202
Entity
Organization
Contact information
Practice address
1717 OAK PARK BLVD, SECOND FLOOR, LAKE CHARLES, LA 70601-8990
(337) 494-4720
(337) 494-4721
Mailing address
1717 OAK PARK BLVD, SECOND AVE, LAKE CHARLES, LA 70601-8990
(337) 494-4720
(337) 494-4721
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0600010034
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9900888
—
LA
01
—
CG9701
RAILROAD MEDICARE
LA
Enumeration date
06/16/2006
Last updated
08/19/2008
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