Organization
OLOL-ASCENSION
Active
Other names
st elizabeth after hours
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN F. FRAICHE M.D. (CEO)
(225) 647-8511
Entity
Organization
Contact information
Practice address
1702 N BURNSIDE AVE, SUITE B, GONZALES, LA 70737-5021
(225) 647-8511
(225) 644-5213
Mailing address
2647 S RIVERVIEW BLVD, SUITE 100, GONZALES, LA 70737-5021
(225) 647-8511
(225) 644-5213
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
013784
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1440400
—
LA
Enumeration date
07/07/2006
Last updated
08/06/2007
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