Glen D. Hurlston, M.D., Apmc

Organization Active NPI Anesthesiology Physician · Leesville, LA

NPI 1306913488 · NPPES record last updated May 28, 2026

Key facts

NPI
1306913488
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
GLEN D. HURLSTON, M.D., APMC
Practice address
1020 W Fertitta Blvd
Leesville, LA 71446-4645
Phone
(337) 239-5114
Fax
(337) 239-5360
NPI assigned
Nov 30, 2006
Organization subpart
No

Authorized official

Name
Kevin Quinn
Title
Ceo
Phone
(337) 239-5114

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 45

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

View all 45

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040826000006 LA Part B Supplier - Clinic/Group Practice 3779557541 Receives reassigned benefits from 35 practitioners
Practice locations: Leesville, LA

National Provider Directory

Locations

300 E McNeese St
Ste 3A
Lake Charles, LA 70605
Phone (318) 480-1117

1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207L00000X Yes

Addresses

Primary practice location

1020 W Fertitta Blvd
Leesville, LA 71446-4645

Mailing address

1020 W Fertitta Blvd
Leesville, LA 71446-4645
Phone (337) 239-5114

Other identifiers

IdentifierTypeStateIssuer
1949914MedicaidLA

Other providers in Leesville, LA

All providers in Leesville, LA · Anesthesiology Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.