Healthcare Provider Details

I. General information

NPI: 1568380061
Provider Name (Legal Business Name): MATTHEW SKYLER LACAZE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 HATTAWAY RD
CALHOUN LA
71225-8549
US

IV. Provider business mailing address

129 HATTAWAY RD
CALHOUN LA
71225-8549
US

V. Phone/Fax

Practice location:
  • Phone: 318-578-1946
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number224931
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: