Organization
LSUMC-S FAMILY PRACTICE MEDICAL
Active
Other names
LSUHSC-S Family Medicine Residency Program
Organization subpart
No
Provider details
NPI number
Authorized official
LEISA P OGLESBY (EXECUTIVE DIR FOR MEDICAL SERVICES)
(318) 675-7629
Entity
Organization
Contact information
Practice address
301 4TH ST STE A, ALEXANDRIA, LA 71301-8411
(318) 441-1030
(318) 441-1050
Mailing address
PO BOX 735328, DALLAS, TX 75373-5328
(318) 441-1030
(318) 441-1050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1948705
—
LA
Enumeration date
10/23/2006
Last updated
04/07/2021
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