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General NPI Number Information
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NPI Number | 1477341899
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Entity Type | Individual
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Provider Name | LISA LEGAUX
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Gender | Female
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Dates
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Enumeration Date | 04/26/2025
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 17000 MEDICAL CENTER DR
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City | BATON ROUGE
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State | LA
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Zip | 70816-3246
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Country | US
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Telephone | 225-752-2470
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Fax |
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Provider Business Mailing Address
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Address Line | 30646 ANDERSON DR
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-2145
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Country | US
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Telephone | 225-200-6161
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 176099
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License Number State | LA
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