Organization
MMG ARCHER INSTITUTE, LLC
Active
Parent organization
MEMORIAL MEDICAL GROUP
Other names
MMG Archer Institute
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMORIAL MEDICAL GROUP
Authorized official
DAWN JOHNSON-HATCHER (CFO)
(337) 494-2094
Entity
Organization
Contact information
Practice address
2829 4TH AVE STE 150, LAKE CHARLES, LA 70601-7897
(337) 480-7800
(337) 474-4552
Mailing address
PO BOX 123977 DEPT 3977, DALLAS, TX 75312-0001
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2509551
—
LA
Enumeration date
07/05/2018
Last updated
12/04/2023
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