Healthcare Provider Details

I. General information

NPI: 1164604757
Provider Name (Legal Business Name): LORI L. RORIGUEZ, M.D. APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 PARKWAY DR STE. A
NATCHITOCHES LA
71457-6276
US

IV. Provider business mailing address

1055 PARKWAY DR STE. A
NATCHITOCHES LA
71457-6276
US

V. Phone/Fax

Practice location:
  • Phone: 318-352-6464
  • Fax: 318-352-2488
Mailing address:
  • Phone: 318-352-6464
  • Fax: 318-352-2488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number022137
License Number StateLA

VIII. Authorized Official

Name: DR. LORI L RODRIGUEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 318-352-6464