OUR LADY OF THE LAKE PHYSICIAN GROUP LLC

BATON ROUGE, LA
NPI1184671455
Doing Business AsOLOL PHYSICIAN SURGICAL SPECIALTY
Entity TypeOrganization
Authorized ContactTAMARA WHITE
Director Of Business Services
225-765-5727
Organization Subpart ?No
Primary Taxonomy207RH0003X Internal Medicine, Hematology & Oncology
Additional Taxonomies208600000X Surgery
208C00000X Colon & Rectal Surgery
2086S0127X Surgery, Trauma Surgery
363L00000X Nurse Practitioner
363A00000X Physician Assistant
Enumeration Date2006-05-30
Last Update Date2013-02-20
Business Address
OUR LADY OF THE LAKE PHYSICIAN GROUP LLC
4950 ESSEN LN
BATON ROUGE, LA 70809-3738
Phone number: 225-767-1311
Mailing Address
OUR LADY OF THE LAKE PHYSICIAN GROUP LLC
8415 GOODWOOD BLVD STE 105
BATON ROUGE, LA 70806-7851
Phone number: 225-765-5727