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General NPI Number Information
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NPI Number | 1356932859
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Entity Type | Organization
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Legal Business Name | CLHG-OAKDALE LLC
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 105 HOSPITAL DR
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City | OAKDALE
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State | LA
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Zip | 71463-3034
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Country | US
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Telephone | 318-335-4320
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Fax |
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Provider Business Mailing Address
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Address Line | 130 HOSPITAL DR
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City | OAKDALE
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State | LA
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Zip | 71463-3035
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROCK BORDELON
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Credential |
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Telephone | 318-226-8202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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