Organization
CENTER FOR ORTHOPAEDICS AND SPINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WALLACE NOBLE MD (MANAGER MEMBER)
(337) 721-7242
Entity
Organization
Contact information
Practice address
1636 ELTON RD STE 201, JENNINGS, LA 70546-3648
(337) 721-7236
Mailing address
1747 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2086S0105X
Surgery of the Hand (Surgery) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
05/06/2021
Last updated
05/06/2021
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