Healthcare Provider Details

I. General information

NPI: 1588235089
Provider Name (Legal Business Name): LOUISIANA FOOT AND ANKLE SURGEONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 BELLE TERRE BLVD STE A
LA PLACE LA
70068-3357
US

IV. Provider business mailing address

401 VETERANS BLVD STE 207
METAIRIE LA
70005-2957
US

V. Phone/Fax

Practice location:
  • Phone: 504-835-1849
  • Fax: 504-835-1768
Mailing address:
  • Phone: 504-835-1849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY DYLAN LAMKIN
Title or Position: OWNER
Credential: DPM
Phone: 903-826-7501