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Organization

UROLOGY SPECIALTY AND SURGERY CENTER OF SOUTHWEST LOUISIANA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH S VERHEECK M.D. (MEDICAL DIRECTOR)
(337) 439-8857
Entity
Organization

Contact information

Practice address
234 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5960
(337) 439-8857
(337) 433-1159
Mailing address
234 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5960
(337) 439-8857
(337) 433-1159

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
42
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1390429
LA
01
2097C
BLUE CROSS BLUE SHIELD
LA
01
490001185
RAILROAD MEDICARE
LA
Enumeration date
11/14/2005
Last updated
07/08/2010
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