Healthcare Provider Details

I. General information

NPI: 1013393677
Provider Name (Legal Business Name): OUR LADY OF LOURDES REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2015
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70508-6917
US

IV. Provider business mailing address

4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70508-6917
US

V. Phone/Fax

Practice location:
  • Phone: 337-470-2147
  • Fax: 337-470-4204
Mailing address:
  • Phone: 337-470-2147
  • Fax: 337-470-4204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER J CLOWERS
Title or Position: VP FINANCE
Credential:
Phone: 337-470-2147