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General NPI Number Information
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NPI Number | 1245201730
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Entity Type | Individual
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Provider Name | DOUGLAS KEITH LACOMBE CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 1701 OAK PARK BLVD
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City | LAKE CHARLES
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State | LA
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Zip | 70601-8911
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Country | US
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Telephone | 337-494-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 171 RAY MILNER RD
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City | IOTA
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State | LA
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Zip | 70543-4300
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Country | US
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Telephone | 337-250-0533
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN752822
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP1156860
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 752822
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP03650
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License Number State | LA
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