OUR LADY OF THE LAKE PHYSICIAN GROUP LLC

BATON ROUGE, LA
NPI1033494943
Entity TypeOrganization
Authorized ContactJEFFREY LIMBOCKER
CFO
225-765-7727
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies207K00000X Allergy & Immunology
207N00000X Dermatology
207Q00000X Family Medicine
207SG0201X Medical Genetics, Clinical Genetics (M.D.)
207Y00000X Otolaryngology
208000000X Pediatrics
208100000X Physical Medicine & Rehabilitation
208200000X Plastic Surgery
2084P0800X Psychiatry & Neurology, Psychiatry
208600000X Surgery
208C00000X Colon & Rectal Surgery
208M00000X Hospitalist
363A00000X Physician Assistant
363L00000X Nurse Practitioner
Enumeration Date2011-10-12
Last Update Date2015-10-08
Business Address
OUR LADY OF THE LAKE PHYSICIAN GROUP LLC
7777 HENNESSY BLVD STE 6002
BATON ROUGE, LA 70808-4300
Phone number: 225-765-7727
Mailing Address
OUR LADY OF THE LAKE PHYSICIAN GROUP LLC
2051 SILVERSIDE DR STE 260
BATON ROUGE, LA 70808-9005
Phone number: 225-490-6301