Healthcare Provider Details

I. General information

NPI: 1699167478
Provider Name (Legal Business Name): CALCASIEU CAMERON EMERGENCY PHYSICIAN GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2015
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 CYPRESS ST
SULPHUR LA
70663-5053
US

IV. Provider business mailing address

PO BOX 721916
NORMAN OK
73070-8460
US

V. Phone/Fax

Practice location:
  • Phone: 337-527-7034
  • Fax:
Mailing address:
  • Phone: 405-240-9381
  • Fax: 405-341-9217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BRETT MCINTYRE
Title or Position: CFO
Credential:
Phone: 850-602-0625