Healthcare Provider Details

I. General information

NPI: 1871302703
Provider Name (Legal Business Name): NORTH OAKS MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15790 PAUL VEGA MD DR
HAMMOND LA
70403-1434
US

IV. Provider business mailing address

PO BOX 2668 BUSINESS CTR - INS CREDENTIALING
HAMMOND LA
70404
US

V. Phone/Fax

Practice location:
  • Phone: 985-345-2700
  • Fax:
Mailing address:
  • Phone: 985-230-1682
  • Fax: 985-230-6652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MARK T ANDERSON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 985-230-6602