LAKE CHARLES MEDICAL SERVICES ORTHOPEDICS LLC (NPI# 1639218407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639218407 |
| Entity Type | Organization |
| Organization Name | LAKE CHARLES MEDICAL SERVICES ORTHOPEDICS LLC |
| Other Organization Name | D DREZ MD AND S HOFER DO |
| Practice Address |
1717 Oak Park Blvd Lake Charles LA 70601-8991 |
| Practice Telephone | 3374944900 |
| Practice Fax Number | 3374944936 |
| Mailing Telephone | 3374944900 |
| Mailing Fax Number | 3374944936 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2008-06-13 |
| Authorized Official Name | MR. DAVID B USHER (SR. V.P. BUSINESS DEVELOPMENT) |
| Authorized Official Telephone | 3374943200 |
| Authorized Official Credential | FACHE |
| Is Organization Subpart | Y |
| Parent Organization Name | LAKE CHARLES MEDICAL SERVICES INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | OCCUPATIONAL LICENSE | 07-00010827 | 01 |
| LA | BCBS | NH6097 | 01 |
| LA | 1030422 | 05 | |
| LA | RAILROAD MCR | DF6777 | 01 |
| Other Name | Type Code |
|---|---|
| D DREZ MD AND S HOFER DO | Doing Business As Name - Organization |
| Street Address |
1717 OAK PARK BLVD |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70601-8991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013910801 | William R Condos Jr. | Internal Medicine | 1717 Oak Park Blvd, Fl 2, Lake Charles, LA 70601-8990 | 2005-05-24 |
| 1467821629 | Courtney Clark | Nurse Practitioner | 1717 Oak Park Blvd, Lake Charles, LA 70601-8991 | 2015-09-17 |
| 1568845899 | Kathy Parker Woodward | Nurse Practitioner | 1717 Oak Park Blvd, 3rd Floor, Lake Charles, LA 70601-8991 | 2015-07-06 |
| 1356730303 | Rikki Monticello | Nurse Practitioner | 1717 Oak Park Blvd, 3rd Floor, Lake Charles, LA 70601-8991 | 2015-01-14 |
| 1831507961 | Rebecca Kindler | Optometrist | 1717 Oak Park Blvd, Ste 1, Lake Charles, LA 70601-8991 | 2014-08-01 |
| 1588007249 | Martin Daniel Castillo | Nurse Practitioner | 1717 Oak Park Blvd, 3rd Fl, Lake Charles, LA 70601-8991 | 2013-04-12 |
| 1043553522 | Amanda Joiner Saltzman | Pharmacist | 1717 Oak Park Blvd, Suite 110, Lake Charles, LA 70601-8991 | 2013-04-03 |
| 1932450210 | Keysha Raye Nabours | Nurse Practitioner | 1717 Oak Park Blvd, 2nd Fl, Lake Charles, LA 70601-8991 | 2012-09-26 |
| 1063778504 | Margaret Young Carter | Ophthalmology | 1717 Oak Park Blvd, #1, Lake Charles, LA 70601-8991 | 2012-04-10 |
| 1598052052 | Ted Etell Fontenot | Nurse Practitioner | 1717 Oak Park Blvd, Second Floor, Lake Charles, LA 70601-8991 | 2011-07-06 |
| Find all providers in the same location | ||||
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457724254 | Collins Orthopaedics LLC | Orthopaedic Surgery | 1625 Wolfe Circle, Lake Charles, LA 70605-2348 | 2015-11-03 |
| 1326229204 | Thomas W Axelrad | Orthopaedic Surgery | 1701 Oak Park Blvd Fl 3, Lake Charles, LA 70601-8911 | 2007-11-19 |
| 1265484539 | Michael Alan Hinton | Orthopaedic Surgery | 230 West Sale Road, Lake Charles, LA 70605 | 2006-05-16 |
| 1376524603 | Jeffrey E Balazsy | Orthopaedic Surgery | 1717 Oak Park Blvd Fl 3, Lake Charles, LA 70601-8990 | 2005-11-14 |
| 1538780630 | Center for Orthopaedics and Spine, LLC | Orthopaedic Surgery | 1727 Imperial Blvd Bldg 1b, Lake Charles, LA 70605-5392 | 2020-04-29 |
| 1962815332 | Michael James Garitty | Orthopaedic Surgery | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2014-06-03 |
| 1982023727 | Kipp Cryar | Orthopaedic Surgery | 1717 Oak Park Blvd Fl 3, Lake Charles, LA 70601-8990 | 2014-04-09 |
| 1639333628 | R Dale Bernauer Md Apmc | Orthopaedic Surgery | 4150 Nelson Rd, Bldg D Ste 1, Lake Charles, LA 70605 | 2008-07-18 |
| 1992983159 | Robert Michael Duarte | Orthopaedic Surgery | 1717 Oak Park Blvd Fl 3, Lake Charles, LA 70601-8990 | 2008-02-09 |
| 1962695361 | Lake Charles Medical Services Orthopaedics Associates LLC | Orthopaedic Surgery | 1717 Oak Park Blvd Fl 3, Lake Charles, LA 70601-8990 | 2007-08-20 |
| Find all providers in LAKE CHARLES | ||||
| City | LAKE CHARLES |
| Zip Code | 70601 |
Please comment or provide details below to improve the information on LAKE CHARLES MEDICAL SERVICES ORTHOPEDICS LLC.
| 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.