NPIMap

Lake Charles Medical Services, Inc

Organization Active NPI Internal Medicine Physician · Lake Charles, LA

NPI 1003545815 · NPPES record last updated Jun 7, 2022

Key facts

NPI
1003545815
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
LAKE CHARLES MEDICAL SERVICES, INC
Practice address
1717 Oak Park Blvd
Lake Charles, LA 70601-8991
Phone
(337) 582-7632
Fax
(337) 582-7656
NPI assigned
Jun 7, 2022
Organization subpart
No

Authorized official

Name
Dawn Johnson
Title
Cfo
Phone
(337) 494-2094

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Family Medical Clinic S (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207R00000X Yes

Addresses

Primary practice location

1717 Oak Park Blvd
Lake Charles, LA 70601-8991

Mailing address

PO Box 123604, Dept 3604
Dallas, TX 75312-0001
Phone (337) 582-7632

Other names

  • IOWA HEALTH CENTER Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 7, 2022.

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1003545815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 123604, DEPT 3604",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753120001",
            "telephone_number": "337-582-7632",
            "fax_number": "337-582-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018991",
            "telephone_number": "337-582-7632",
            "fax_number": "337-582-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CHARLES MEDICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-494-2094"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IOWA HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

All providers in Lake Charles, LA · Internal Medicine Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.