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General NPI Number Information
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NPI Number | 1720652175
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Entity Type | Individual
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Provider Name | LAINE ALEXANDRA LYLES DO
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Gender | Female
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Dates
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Enumeration Date | 05/19/2021
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 433 BOLIVAR ST
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City | NEW ORLEANS
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State | LA
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Zip | 70112-7021
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Country | US
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Telephone | 504-568-4808
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Fax |
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Provider Business Mailing Address
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Address Line | 2327 OCTAVIA ST
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City | NEW ORLEANS
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State | LA
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Zip | 70115-6531
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Country | US
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Telephone | 318-446-2532
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Fax | 803-434-4160
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LL83600
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 340742
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License Number State | LA
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