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 B, 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) 638-8661, or through Sharbaugh, Elona via phone (225) 490-8806.
Contact Information
Primary practice address
230 Roberts Dr Suite B
New Roads LA 70760-2661
Phone: (225) 638-8661
Fax: (225) 638-2977
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X |
Profile Details
| NPI number | 1356480214 |
|---|---|
| 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 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 | 1356480214 | NPPES |
| Louisiana | MEDICAID | 1447510 |
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