Healthcare Provider Details
I. General information
NPI: 1447761226
Provider Name (Legal Business Name): LOUISIANA ORTHOPAEDIC SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2017
Last Update Date: 10/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4231 AMBASSADOR CAFFERY PKWY SUITE 102
LAFAYETTE LA
70508
US
IV. Provider business mailing address
108 RUE LOUIS XIV
LAFAYETTE LA
70508
US
V. Phone/Fax
- Phone: 337-235-8007
- Fax:
- Phone: 337-235-8007
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
HEBERT
Title or Position: MD
Credential:
Phone: 337-235-8007