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LAKEVIEW REGIONAL PHYSICIAN GROUP LLC NPI 1285890467


NPI Information

NPI: 1285890467
Provider Name: LAKEVIEW REGIONAL PHYSICIAN GROUP LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 19D0906970

Address:
130 LAKEVIEW CIRCLE
COVINGTON, LA
ZIP 70433
Phone: (985) 892-6858
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LAKEVIEW REGIONAL PHYSICIAN GROUP LLC is a pediatrics in Covington, LA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. LAKEVIEW REGIONAL PHYSICIAN GROUP LLC NPI is 1285890467. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

130 LAKEVIEW CIRCLE
COVINGTON, LA
ZIP 70433-001
Phone: (985) 892-6858
Fax: (866) 457-6080

The provider's authorized official is John Rebok .
The authorized official title is Group Vice President/ao and has the following contact phone number (615) 377-5004.

The CLIA number assigned to this NPI record is 19D0906970 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/6/2008 and was last updated on 6/9/2022.


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
1208000000XPediatricsYes

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
11384313MEDICAIDLOUISIANA
200837785MEDICAIDMISSISSIPPI

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

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