institution
Our Lady Of The Lake Physician Group, Llc
Rural Health Clinic/Center in Maurepas, Louisiana
NPI 1134152630

Our Lady Of The Lake Physician Group, Llc is a Rural Health Clinic/Center based in Maurepas, LA and is specialized in Rural Health. Our Lady Of The Lake Physician Group, Llc practices in Maurepas, LA. The NPI Number for Our Lady Of The Lake Physician Group, Llc is 1134152630 and holds a License No. (Louisiana).

The current practice location address for Our Lady Of The Lake Physician Group, Llc is 18740 Highway 22, Maurepas, LA and can be reached out via phone at 225-698-3435 and via fax at 225-698-6446.

Location: 18740 Highway 22, Maurepas, LA, 70449-3018
institution
Provider Profile Details
NPI Number
1134152630
Provider Name
Our Lady Of The Lake Physician Group, Llc
Credential
Provider Entity Type
Organization
Address
18740 Highway 22, Maurepas, LA, 70449-3018
Phone Number
225-698-3435
Fax Number
225-698-6446
Provider Enumeration Date
07/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1408239 05 LA
institution
Provider Business Practice Location Address Details
Address
18740 Highway 22
City
State
Zip
70449-3018
Phone Number
225-698-3435
Fax Number
225-698-6446
person
Provider Business Mailing Address Details
Address
18740 Highway 22
City
State
Zip
70449-3018
Phone Number
225-698-3435
Fax Number
225-698-6446
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
115 (Louisiana)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rural Health
Taxonomy
License No.
()
Definition
Definition to come...
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