Laura F Black (NPI# 1760748131, PAC ID# 7214158500) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1760748131 |
| PAC ID by PECOS | 7214158500 |
| Professional Enrollment ID | I20141030001556 |
| Full Name | Laura F Black |
| Organization Legal Name | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Address |
1937 S Burnside Ave Gonzales LA 70737-4632 |
| Phone Number | 2256478511 |
| Gender | F |
| Graduation Year | 2011 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4587849781 |
| Number of Group Practice Members | 474 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190064 | OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 7777 Hennessy Blvd, Baton Rouge, LA 70808-4363 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC | |
| 1937 S Burnside Ave, Gonzales, LA 70737-4632 | 2256478511 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Organization Legal Name | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Physicians | 443 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Michael Robinson | Family Medicine | Our Lady of The Lake Physician Group LLC | 12525 Perkins Rd A, Baton Rouge, LA 70810-1907 |
| Kori Fogg Juban | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 34870 La Hwy 1019, Denham Springs, LA 70706-0659 |
| Michelle Duhe | Family Medicine | Our Lady of The Lake Physician Group LLC | 26739 La Hwy 1032, Denham Springs, LA 70726-4926 |
| Swapna G Kallu | Internal Medicine | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Montrell Martin-duhe | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 4463 La Hwy 1 S A, Port Allen, LA 70767-5990 |
| Joshua R Clark | Family Medicine | Our Lady of The Lake Physician Group LLC | 59315 River W Dr, Suite C, Plaquemine, LA 70764-6553 |
| Hollie B Ortis | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 13489 Hwy 431, Suite A, Saint Amant, LA 70774-3213 |
| Shantan Ravula | Family Medicine | Our Lady of The Lake Physician Group LLC | 14225 Hwy 73, Prairieville, LA 70769-3616 |
| Daniel Kevin Lavie | Hematology/oncology | Our Lady of The Lake Physician Group LLC | 4950 Essen Ln, Suite 400, Baton Rouge, LA 70809-3738 |
| Sheri A Ammons | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 5428 Odonovan Dr B, Baton Rouge, LA 70808-4374 |
| Street Address |
1937 S BURNSIDE AVE |
| City | GONZALES |
| State | LA |
| Zip | 70737-4632 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sandhya D Mani | Allergy/immunology | Our Lady of The Lake Physician Group LLC | 1937 S Burnside Ave, Gonzales, LA 70737-4632 |
| Theron Garrick Mccormick | Allergy/immunology | Our Lady of The Lake Physician Group LLC | 1937 S Burnside Ave, Gonzales, LA 70737-4632 |
| John D Knapp | Internal Medicine | Our Lady of The Lake Physician Group LLC | 1937 S Burnside Ave, Gonzales, LA 70737-4632 |
| Brittany Carrere Hortin | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 1937 S Burnside Ave, Gonzales, LA 70737-4632 |
| Lisa K Le | Pediatric Medicine | Our Lady of The Lake Physician Group LLC | 1937 S Burnside Ave, Gonzales, LA 70737-4632 |
| Paula D Julian | Nurse Practitioner | Our Lady of Lake Ascension, LLC | 1937 S Burnside Ave, Gonzales, LA 70737-4632 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hailey R Entremont | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 1702 N Burnside Ave, Suite A, Gonzales, LA 70737-2141 |
| Sharon D Lobell | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 1702 N Burnside Ave, Suite A, Gonzales, LA 70737-2141 |
| Paul C Aguillard Jr. | Pediatric Medicine | Our Lady of The Lake Physician Group LLC | 1702 N Burnside Ave, Suite A, Gonzales, LA 70737-2141 |
| Annie K Lanclos | Nurse Practitioner | Lake Urgent Care Ascension LLC | 1702 N Burnside Ave, Lake Urgent Care Gonzales, Gonzales, LA 70737-2141 |
| Raymond Dyer | Physical Therapy | Alliance Therapy Services, Inc | 12320 Hwy 44 3f, Gonzales, LA 70737-2202 |
| Veronica D Walker | Qualified Speech Language Pathologist | Alliance Therapy Services, Inc | 12320 Hwy 44 3f, Gonzales, LA 70737-2202 |
| Donna P Aguillard | Occupational Therapy | Alliance Therapy Services, Inc | 12320 Hwy 44 3f, Gonzales, LA 70737-2202 |
| Jeremy C Catoire | Physical Therapy | 12550 Airline Hwy, Suite 102, Gonzales, LA 70737-2258 | |
| Brian S Christopherson | Optometry | 308 N Airline, Brian S Christopherson Od, Gonzales, LA 70737-3009 | |
| Phillip L Smith | Chiropractic | 208 E Cornerview St, Smith Chiropractic Clinic, Gonzales, LA 70737-3150 | |
| Find all physicians in zip 70737 | |||
| City | GONZALES |
| Zip Code | 70737 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | GONZALES + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Laura F Black.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.