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SOUTHPARK COMMUNITY HOSPITAL NPI 1275513798


NPI Information

NPI: 1275513798
Provider Name: SOUTHPARK COMMUNITY HOSPITAL
Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Organization
Address:
314 YOUNGSVILLE HWY
LAFAYETTE, LA
ZIP 70508
Phone: (337) 769-4080
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SOUTHPARK COMMUNITY HOSPITAL is an oral maxillofacial surgery in Lafayette, LA. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. SOUTHPARK COMMUNITY HOSPITAL NPI is 1275513798. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

314 YOUNGSVILLE HWY
LAFAYETTE, LA
ZIP 70508-524
Phone: (337) 769-4080

The provider's authorized official is Linda Deville .
The authorized official title is Ceo and has the following contact phone number (337) 769-4080.

The enumeration date for this NPI number is 1/19/2006 and was last updated on 8/22/2020.


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
1204E00000XOral & Maxillofacial SurgeryYes
2204F00000XTransplant SurgeryX
3207KI0005XAllergy & ImmunologyClinical & Laboratory ImmunologyX
4207L00000XAnesthesiologyX
5207R00000XInternal MedicineX
6207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismX
7207RN0300XInternal MedicineNephrologyX
82085R0202XRadiologyDiagnostic RadiologyX
9208600000XSurgeryX
10208800000XUrologyX
11208D00000XGeneral PracticeX

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
11729388MEDICAIDLOUISIANA
261343OTHERLOUISIANABLUE CROSS

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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