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OUR LADY OF THE LAKE PHYSICIAN GROUP LLC NPI 1033494943


NPI Information

NPI: 1033494943
Provider Name: OUR LADY OF THE LAKE PHYSICIAN GROUP LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 19D0878491

Address:
7777 HENNESSY BLVD
STE 6002
BATON ROUGE, LA
ZIP 70808
Phone: (225) 765-7727
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OUR LADY OF THE LAKE PHYSICIAN GROUP LLC is an internal medicine in Baton Rouge, LA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. OUR LADY OF THE LAKE PHYSICIAN GROUP LLC NPI is 1033494943. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7777 HENNESSY BLVD
STE 6002
BATON ROUGE, LA
ZIP 70808-300
Phone: (225) 765-7727
Fax: (225) 766-5645

The provider's authorized official is Jeffrey Limbocker .
The authorized official title is Cfo and has the following contact phone number (225) 765-7727.

The CLIA number assigned to this NPI record is 19D0878491 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/12/2011 and was last updated on 10/8/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207K00000XAllergy & ImmunologyNo
2207N00000XDermatologyNo
3207Q00000XFamily MedicineNo
4207SG0201XMedical GeneticsClinical Genetics (M.D.)No
5207Y00000XOtolaryngologyNo
6208000000XPediatricsNo
7208100000XPhysical Medicine & RehabilitationNo
8208200000XPlastic SurgeryNo
92084P0800XPsychiatry & NeurologyPsychiatryNo
10208600000XSurgeryNo
11208C00000XColon & Rectal SurgeryNo
12208M00000XHospitalistNo
13363A00000XPhysician AssistantNo
14363L00000XNurse PractitionerNo
15207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15DX80MEDICARE PINLOUISIANA
22305042MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.