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Contact Information

MID STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER, LLC
3444 MASONIC DRIVE
ALEXANDRIA, LA71301
 Phone: 318-473-9556
 Fax: 318-441-8339
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for MID STATE ORTHOPAEDIC SPORTS MEDICINE CENTER LLC · (Female)

NPI # 1104890052
Status Active
Credentials
Entity Individual
Enumeration date 02/16/2006
Last updated 03/24/2026 - About 2 months ago
Sole proprietor 1 Not specified
Identifiers
  • LA Medicaid 1946320
  • LA Other 0570570001 MEDICARE DME GROUP #
  • LA Other CD7720 RAILROAD MEDICARE PALMETT
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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