Lakeside Women'S Specialty Center, Apmc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

LAKESIDE WOMEN'S SPECIALTY CENTER, APMC

Practice address

4315 Houma Blvd
Suite 500
Metairie, LA 70006-2940

Phone

(504) 885-8563

Fax

(504) 455-1072

NPI assigned

Oct 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathryn G Wild, M.D.

Title

President

Phone

(504) 885-8563

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104907807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 HOUMA BLVD",
            "address_2": "SUITE 500",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062940",
            "telephone_number": "504-885-8563",
            "fax_number": "504-455-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 HOUMA BLVD",
            "address_2": "SUITE 500",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062940",
            "telephone_number": "504-885-8563",
            "fax_number": "504-455-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE WOMEN'S SPECIALTY CENTER, APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILD",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-885-8563",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942561",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lainie Breaux, LLC
• Lake Wellness Center, LLC
• Lakeside Counseling Center
• Lakeside Dental Associates, Inc.
• Lakeside Dental Care
• Lakeside Womens Services LLC
• Lakeview Urgent Care, LLC
• Hope Elizabeth Lalla
• Kelly Nhu Lam
• Tiffany Kim Thuy Lam

• Obstetrics & Gynecology Physician in Metairie, LA
• Providers in Metairie, LA by specialty
• Obstetrics & Gynecology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.