Organization
DEER CREEK MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA THOMPSON CMPM (BUSINESS MANAGER)
(337) 238-0167
Entity
Organization
Contact information
Practice address
301 W FERTITTA BLVD STE 1, LEESVILLE, LA 71446-4665
(337) 238-0167
(337) 238-0574
Mailing address
301 W FERTITTA BLVD STE 1, LEESVILLE, LA 71446-4665
(337) 238-0167
(337) 238-0574
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1949477
—
LA
Enumeration date
07/01/2006
Last updated
05/24/2011
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