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NPI Code Detail

MEDICARE: ORTHOPAEDIC & SPORTS CLINIC

MEDICARE: ORTHOPAEDIC & SPORTS CLINIC
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
1207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1992983092
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORTHOPAEDIC & SPORTS CLINIC
Provider Business Mailing Address
First Line : 1014 W SAINT CLARE BLVD
Second Line : SUITE 1020
City : GONZALES
State : LA
Zip : 70737-5027
Country : US
Telephone Number : 225-743-2000
Fax Number : 225-743-2010
Provider Business Practice Location Address
First Line : 1014 W SAINT CLARE BLVD
Second Line : SUITE 1020
City : GONZALES
State : LA
Zip : 70737-5027
Country : US
Telephone Number : 225-743-2000
Fax Number : 225-743-2010
Authorized Official
Title or Position : OFFICE MANAGER
Name : DENISE FARRELL
Credential :
Telephone Number : 225-743-2000
Provider Enumeration Date : 01/31/2008
Last Update Date : 08/15/2011

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Directions to “ORTHOPAEDIC & SPORTS CLINIC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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