Healthcare Provider Details

I. General information

NPI: 1215290796
Provider Name (Legal Business Name): NORTH OAKS PHYSICIAN GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42401 PELICAN PROFESSIONAL PARK
HAMMOND LA
70403-2405
US

IV. Provider business mailing address

PO BOX 1608
HAMMOND LA
70404-1608
US

V. Phone/Fax

Practice location:
  • Phone: 985-542-9155
  • Fax: 985-542-9133
Mailing address:
  • Phone: 985-542-9155
  • Fax: 985-542-9133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SHIRLEY HSING
Title or Position: SR. V.P. / C.F.O.
Credential:
Phone: 985-230-6655