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NPI Code Detail

MEDICARE: OBTELECARE LOUISIANA LLC

MEDICARE: OBTELECARE LOUISIANA LLC
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
1207P00000XEmergency Medicine Physician
2207V00000XObstetrics & Gynecology Physician
3208M00000XHospitalist Physician
4207VM0101XMaternal & Fetal Medicine Physician

General Provider Information

NPI Number : 1245185982
Entity Type Code : Organization
Provider Name (Legal Business Name) : OBTELECARE LOUISIANA LLC
Provider Business Mailing Address
First Line : 777 LOWNDES HILL RD BLDG 1
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-2101
Country : US
Telephone Number : 864-908-3530
Fax Number :
Provider Business Practice Location Address
First Line : 3330 MASONIC DR
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-3841
Country : US
Telephone Number : 864-908-3530
Fax Number :
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : DENISE BURNS
Credential :
Telephone Number : 864-908-3530
Provider Enumeration Date : 02/27/2026
Last Update Date : 02/27/2026

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Directions to “OBTELECARE LOUISIANA LLC ” Practice Location

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