Organization · Type 2 NPI

Our Lady of the Lake Physician Group LLC

Cardiovascular Disease Physician · Baton Rouge, LA

NPI number 1356643399 Active

Practice location

8415 Goodwood Blvd, Ste 105
Baton Rouge, LA 70806-7851

Fax (225) 765-4278

Specialties and licenses

Taxonomy	Code	License
Cardiovascular Disease Physician Primary	207RC0000X	None listed

Cardiovascular Disease Physician: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

30 other providers at this address

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NPI record

NPI: 1356643399
Entity type: Organization (Type 2)
Issued: Nov 24, 2010
Last updated: Nov 24, 2010
Status: Active
Subpart: Yes of Our Lady of the Lake Physician Group LLC

Other names

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Lake Physician Group Cardiology Ser · doing business as

Authorized official

Elona Sharbaugh
VP Physician Practices
(225) 765-8680

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About NPI 1356643399

Our Lady of the Lake Physician Group LLC's National Provider Identifier is 1356643399, issued on Nov 24, 2010. The primary taxonomy on file is Cardiovascular Disease Physician (207RC0000X), and the practice location is in Baton Rouge, LA. The record was last updated on Nov 24, 2010.