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Contact Information

MID STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER LLC
504 JACK MILLER ROAD
VILLEPLATTE, LA70586
 Phone: 318-473-9556
 Fax: 318-484-6032
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

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

NPI # 1447707583
Status Active
Credentials
Entity Individual
Enumeration date 09/07/2016
Last updated 04/26/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers
  • LA License # 9317843
  • LA Medicaid 1946320
  • LA Other CD7720 RAILROAD MEDICARE
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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