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NPI Code Detail

MEDICARE: LGH ONCOLOGY CLINIC

MEDICARE: LGH ONCOLOGY CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology PhysicianMD.08523RLA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225133622
Entity Type Code : Organization
Provider Name (Legal Business Name) : LGH ONCOLOGY CLINIC
Provider Business Mailing Address
First Line : P.O. DRAWER 1368
Second Line :
City : RUSTON
State : LA
Zip : 71273-1368
Country : US
Telephone Number : 318-254-2100
Fax Number : 318-254-2728
Provider Business Practice Location Address
First Line : 401 E VAUGHN AVE
Second Line :
City : RUSTON
State : LA
Zip : 71270-5950
Country : US
Telephone Number : 318-254-2100
Fax Number : 318-254-2781
Authorized Official
Title or Position : CEO
Name : MR. THOMAS J STONE
Credential :
Telephone Number : 318-254-2453
Provider Enumeration Date : 09/13/2006
Last Update Date : 08/22/2020

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