Healthcare Provider Details

I. General information

NPI: 1467816595
Provider Name (Legal Business Name): PARKER GEORGE LAVIGNE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 DR MICHAEL DEBAKEY DR
LAKE CHARLES LA
70601-5724
US

IV. Provider business mailing address

501 DR MICHAEL DEBAKEY DR
LAKE CHARLES LA
70601-5724
US

V. Phone/Fax

Practice location:
  • Phone: 337-312-8281
  • Fax: 337-497-1173
Mailing address:
  • Phone: 337-312-8281
  • Fax: 337-497-1173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number312109
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number312109
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: