Organization
UROLOGY CENTER OF SOUTHWEST LOUISIANA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH STEVEN VERHEECK M.D. (PRESIDENT)
(337) 433-5282
Entity
Organization
Contact information
Practice address
234 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5960
(337) 433-5282
(337) 433-1159
Mailing address
234 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5960
(337) 433-5282
(337) 433-1159
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1795411
—
LA
01
—
760760185
UNITED HEALTHCARE
LA
01
—
7607601850
BLUE CROSS BLUE SHIELD
LA
01
—
CP2688
RAILROAD MEDICARE
LA
Enumeration date
07/14/2006
Last updated
04/04/2011
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