Organization
LAKE CHARLES MEDICAL & SURGICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRIS HICKINGBOTTOM (CEO)
(337) 433-8400
Entity
Organization
Contact information
Practice address
4320 LAKE ST, LAKE CHARLES, LA 70605-4310
(337) 433-8400
Mailing address
501 S RYAN ST, LAKE CHARLES, LA 70601-5724
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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