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OUR LADY OF LAKE ASCENSION LLC NPI 1306899067


NPI Information

NPI: 1306899067
Provider Name: OUR LADY OF LAKE ASCENSION, LLC

Doing Business As: ST ELIZABETH PHYSICIANS

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 19D0711456

Address:
2647 S ST. ELIZABETH BLVD
SUITE 100
GONZALES, LA
ZIP 70737
Phone: (225) 647-8511
Get Directions

OUR LADY OF LAKE ASCENSION, LLC is a family medicine in Gonzales, LA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. OUR LADY OF LAKE ASCENSION, LLC NPI is 1306899067. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As St Elizabeth Physicians.

The provider's business location address is:

2647 S ST. ELIZABETH BLVD
SUITE 100
GONZALES, LA
ZIP 70737-021
Phone: (225) 647-8511
Fax: (225) 644-5213

The provider's authorized official is John F. Fraiche .
The authorized official title is President and has the following contact phone number (225) 647-8511.

The CLIA number assigned to this NPI record is 19D0711456 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 3/4/2015.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine013784LOUISIANAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11949892MEDICAIDLOUISIANA
25C550MEDICARE PINLOUISIANA

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: 5/5/2024

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