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Contact Information

OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER
8415 GOODWOOD BLVD
SUITE 105
BATON ROUGE, LA70806-7851
 Phone: 225-765-4361
 Fax: 225-765-4062
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Pulmonology

2080P0214X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER · (Female)

NPI # 1235263724
Status Active
Credentials
Entity Individual
Enumeration date 03/15/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • LA Medicaid 1445584
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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