Organization
OUR LADY OF THE LAKE HOSPITAL INC
Active
Other names
Pediatric Specialty Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA WHITE (DIRECTOR OF BUSINESS SERVICES)
(225) 765-4251
Entity
Organization
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 766-5204
(225) 765-4062
Mailing address
8415 GOODWOOD BLVD, STE 105, BATON ROUGE, LA 70806-7851
(225) 765-4226
(225) 765-9244
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
2080P0210X
Pediatric Nephrology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08775372
—
MS
05
—
1447129
—
LA
Enumeration date
05/20/2006
Last updated
05/11/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us