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General NPI Number Information
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NPI Number | 1518146497
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Entity Type | Organization
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Legal Business Name | LAKESIDE WOMENS SERVICES LLC
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 4700 S I 10 SERVICE RD W SUITE 205
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City | METAIRIE
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State | LA
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Zip | 70001-1269
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Country | US
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Telephone | 504-988-6872
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Fax | 504-988-6288
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Provider Business Mailing Address
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Address Line | 1415 TULANE AVE HC71
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City | NEW ORLEANS
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State | LA
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Zip | 70112-2600
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Country | US
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Telephone | 504-988-7535
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Fax | 504-988-6288
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. ROBERT LAGESSE
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Credential |
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Telephone | 504-988-7535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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