Organization
OUR LADY OF THE LAKE PLASTIC CLINIC
Active
Parent organization
OUR LADY OF THE LAKE HOSPITAL, INC.
Other names
Our Lady of the Lake Regional Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
OUR LADY OF THE LAKE HOSPITAL, INC.
Authorized official
MR. TAMARA D WHITE JR. (DIRECTOR OF BUSINESS SERVICES)
(225) 765-4251
Entity
Organization
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 709, BATON ROUGE, LA 70808-4300
(225) 765-7731
Mailing address
7777 HENNESSY BLVD, SUITE 709, BATON ROUGE, LA 70808-4300
(225) 765-7731
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
08/05/2007
Last updated
05/19/2011
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