Healthcare Provider Details

I. General information

NPI: 1629015573
Provider Name (Legal Business Name): LSUMC UNIVERSITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 W CONGRESS ST
LAFAYETTE LA
70506-4205
US

IV. Provider business mailing address

2390 W CONGRESS ST
LAFAYETTE LA
70506-4205
US

V. Phone/Fax

Practice location:
  • Phone: 337-261-6000
  • Fax: 337-261-6003
Mailing address:
  • Phone: 337-261-6000
  • Fax: 337-261-6003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL K BUTLER
Title or Position: ACTING CEO
Credential: M.D.
Phone: 225-922-0775