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NPI Code Detail

MEDICARE: DOUGLAS KEITH LACOMBE CRNA

MEDICARE: DOUGLAS KEITH LACOMBE CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistRN752822TX
2367500000XCertified Registered Nurse AnesthetistAP1156860TX
3367500000XCertified Registered Nurse Anesthetist752822TX
4367500000XCertified Registered Nurse AnesthetistAP03650LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P01030980OTHERTXRAILROAD
38854UBOTHERTXBCBS

General Provider Information

NPI Number : 1245201730
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS KEITH LACOMBE CRNA
Provider Business Mailing Address
First Line : 171 RAY MILNER RD
Second Line :
City : IOTA
State : LA
Zip : 70543-4300
Country : US
Telephone Number : 337-250-0533
Fax Number :
Provider Business Practice Location Address
First Line : 1701 OAK PARK BLVD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-8911
Country : US
Telephone Number : 337-494-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 03/31/2025

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Directions to “ DOUGLAS KEITH LACOMBE CRNA” Practice Location

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