Olol Physician Surgical Specialty
LBN: Our Lady Of The Lake Physician Group Llc
Olol Physician Surgical Specialty is an health care organization with primary practice located at 4950 Essen Ln , Baton Rouge LA 70809-3738. The organization recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology & Oncology, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Hematology & Oncology is the primary health care specialty.
Our Lady Of The Lake Physician Group Llc can be contacted via phone (225) 767-1311, or through White, Tamara via phone (225) 765-5727.
Contact Information
Primary practice address
4950 Essen Ln
Baton Rouge LA 70809-3738
Phone: (225) 767-1311
Fax: (225) 767-1335
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | ||
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | ||
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | ||
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X |
Profile Details
| NPI number | 1184671455 |
|---|---|
| LBN Legal business name | Our Lady Of The Lake Physician Group Llc |
| DBA Doing business as | Olol Physician Surgical Specialty |
| Authorized official | White, Tamara |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 30th, 2006 |
| Last updated | Feb 20th, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184671455 | NPPES |
| Mississippi | MEDICAID | 05684711 | |
| Mississippi | MEDICAID | 1447218 |
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