STACY MCBROOM (NPI# 1346267077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1346267077 |
Entity Type | Individual |
Full Name | STACY MCBROOM |
Credential | DO |
Practice Address |
2016 Oak Park Blvd Lake Charles LA 70601-7828 |
Practice Telephone | 3374778861 |
Practice Fax Number | 3374773092 |
Mailing Telephone | 3374778861 |
Mailing Fax Number | 3374773092 |
Enumeration Date | 2006-07-17 |
Last Update Date | 2008-04-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208800000X | Urology | DO000034 | LA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | 1318540 | 05 |
Street Address |
2016 OAK PARK BLVD |
City | LAKE CHARLES |
State | LA |
Zip Code | 70601-7828 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417934373 | Reed A Fontenot Jr. | Urology | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2005-12-30 |
1275142168 | Nicole Ardoin | Behavioral Analyst | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2020-07-27 |
1386106995 | Linda Rae-leigh Johnson | Behavioral Analyst | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2019-04-02 |
1447711577 | Shelby Sonnier | Behavioral Analyst | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2019-03-29 |
1093209322 | Sarah Coco Egnatuk | Behavioral Analyst | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2018-06-20 |
1609388107 | Jennifer Jolly | Behavioral Analyst | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2017-10-25 |
1518479013 | Michelle Angelica Stokes | Behavioral Analyst | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2017-10-25 |
1376052456 | Channing Ann Langlinais | Behavioral Analyst | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2017-09-21 |
1205285129 | Kayla Wilburn | Behavioral Analyst | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2016-06-10 |
1437424991 | Southwest Louisiana Independence Center, Inc | Community/Behavioral Health | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2012-03-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144833872 | Fresenius Medical Care Sulphur, LLC | Clinic/Center | 330 Chavanne Street, Lake Charles, LA 70601 | 2020-08-24 |
1174158844 | Andrea Cormier | Peer Specialist | 751 E Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2020-03-03 |
1588297303 | Vivian Claire Miller Monceaux | Chiropractor | 780 Bayou Pines East Drive, Lake Charles, LA 70601 | 2020-02-20 |
1568001014 | Swla Center for Health Services | Clinic/Center | 3820 Senator J. Bennett Johnston Ave, Charleston Bldg 8, Lake Charles, LA 70601 | 2020-01-02 |
1417512070 | Ryan Nathaniel Vaisler | Student in an Organized Health Care Education/Training Program | 1525 Oak Park Blvd., Lake Charles, LA 70601 | 2019-05-08 |
1336600675 | Hoh Palliative Care, LLC | Family Medicine | 750 East Bayou Pines, Suite A, Lake Charles, LA 70601 | 2019-03-28 |
1073079026 | Alawrass LLC | Pharmacy | 803 E Prien Lake Rd, Lake Charles, LA 70601 | 2019-02-14 |
1861962722 | Ellaweena Woods | Counselor | 1409 Kirkman St., Lake Charles, LA 70601 | 2018-12-04 |
1770051963 | Hanna Marie Rodriguez | Counselor | 751 Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2018-11-06 |
1023585213 | Shandora Druilhet | Case Manager/Care Coordinator | 751 E Bayou Pines, Lake Charles, LA 70601 | 2018-10-26 |
Find all providers in zip 70601 |
Taxonomy Code | 208800000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861794745 | John Richard Enright | Urology | 4080 Locke Ln, Lake Charles, LA 70605-2258 | 2010-11-26 |
1558491803 | Lake Charles Medical Services Urology LLC | Urology | 2770 3rd Ave Ste 240, Lake Charles, LA 70601-8994 | 2007-03-06 |
1457453722 | John W Melton Md & Reed A Fontenot Jr Md Apmc | Urology | 2016 Dak Park Blvd, Lake Charles, LA 70601-7828 | 2006-09-05 |
1417934373 | Reed A Fontenot Jr. | Urology | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2005-12-30 |
1043201569 | James Jeffery Jancuska | Urology | 401 Dr Michael Debakey Dr, Lake Charles, LA 70601-5864 | 2005-11-03 |
1205827094 | Kenneth Steven Verheeck | Urology | 234 Dr Michael Debakey Dr, Lake Charles, LA 70601-5960 | 2005-11-02 |
1326449430 | Urology Center | Urology | 234 Dr Michael Debakey Dr, Lake Charles, LA 70601-5960 | 2014-09-08 |
1598770869 | John H Upshaw Jr. | Urology | 2016 Oak Park Blvd, Lake Charles, LA 70601-7828 | 2006-07-29 |
1619993672 | Urology Center of Southwest Louisiana Inc | Urology | 234 Dr Michael Debakey Dr, Lake Charles, LA 70601-5960 | 2006-07-14 |
1346231065 | Farjaad Siddiq | Urology | 234 Dr Michael Debakey Dr, Lake Charles, LA 70601-5960 | 2005-11-02 |
Find all providers in LAKE CHARLES |
City | LAKE CHARLES |
Zip Code | 70601 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.