| Avail Lc Physician Group, Llc | |
|
3730 Nelson Rd Lake Charles LA 70605-2412 | |
| (337) 656-7700 | |
| (337) 475-0128 |
| Full Name | Avail Lc Physician Group, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3730 Nelson Rd, Lake Charles, Louisiana |
| Authorized Official Name and Position | Patty Crochet (BILLING OFFICE MANAGER) |
| Authorized Official Contact | 3736567700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avail Lc Physician Group, Llc 3730 Nelson Rd Lake Charles LA 70605-2412 Ph: (337) 656-7700 | Avail Lc Physician Group, Llc 3730 Nelson Rd Lake Charles LA 70605-2412 Ph: (337) 656-7700 |
| NPI Number | 1275171357 |
|---|---|
| Provider Enumeration Date | 12/19/2019 |
| Last Update Date | 12/19/2019 |
| Medicare PECOS PAC ID | 1456762525 |
|---|---|
| Medicare Enrollment ID | O20201120000432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275171357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | David J Landry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811281314 PECOS PAC ID: 4385880616 Enrollment ID: I20130411000282 |
| Provider Name | Jennifer Powers Trombatore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346893732 PECOS PAC ID: 3173955366 Enrollment ID: I20191108000518 |
| Provider Name | Lexie Kober |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508476383 PECOS PAC ID: 2567870785 Enrollment ID: I20210427003083 |
| Provider Name | Kody M. Daigle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144958232 PECOS PAC ID: 9638536915 Enrollment ID: I20230531002814 |
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