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MMG NELSON RD LLC NPI 1295103844


NPI Information

NPI: 1295103844
Provider Name: MMG NELSON RD LLC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 19D2153570

Address:
4345 NELSON RD STE 102
LAKE CHARLES, LA
ZIP 70605
Phone: (337) 480-7900
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MMG NELSON RD LLC is a general practice in Lake Charles, LA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MMG NELSON RD LLC NPI is 1295103844. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4345 NELSON RD STE 102
LAKE CHARLES, LA
ZIP 70605-183
Phone: (337) 480-7900
Fax: (337) 602-6358

The provider's authorized official is Dawn Johnson-hatcher .
The authorized official title is Cfo and has the following contact phone number (337) 494-2094.

The CLIA number assigned to this NPI record is 19D2153570 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/11/2015 and was last updated on 12/4/2023.


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
12084N0400XPsychiatry & NeurologyNeurologyNo
2208D00000XGeneral PracticeYes

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.