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General NPI Number Information
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NPI Number | 1578614707
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC CENTER OF LA LLC
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 500 S 6TH ST STE A
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City | LEESVILLE
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State | LA
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Zip | 71446-4442
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Country | US
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Telephone | 337-239-8000
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Fax | 337-239-8003
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Provider Business Mailing Address
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Address Line | 500 S 6TH ST STE A
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City | LEESVILLE
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State | LA
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Zip | 71446-4442
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Country | US
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Telephone | 337-239-8000
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Fax | 337-239-8003
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JOHN DAVID DELAPP
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Credential | MD
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Telephone | 337-239-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 12067R
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License Number State | LA
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