Our Lady Of The Lake Physician Group Llc

LBN: Our Lady Of The Lake Physician Group Llc
Our Lady Of The Lake Physician Group Llc is an health care organization with primary practice located at 230 Roberts Dr Suite H, New Roads LA 70760-2661. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Our Lady Of The Lake Physician Group Llc can be contacted via phone (225) 638-7033, or through Sharbaugh, Elona via phone (225) 490-8806.

Contact Information

Primary practice address
230 Roberts Dr Suite H New Roads LA 70760-2661
Phone: (225) 638-7033
Fax: (225) 638-7034
Website:
Map and Directions
Authorized official contact:
Name: Sharbaugh, Elona
Phone: (225) 490-8806

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1174662035
LBN Legal business name Our Lady Of The Lake Physician Group Llc
DBA Doing business as
Authorized official Sharbaugh, Elona
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 6th, 2007
Last updated Dec 10th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174662035 NPPES
Louisiana MEDICAID 1447501

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