Provider Demographics
NPI:1134130222
Name:LSA, A PMC
Entity Type:Organization
Organization Name:LSA, A PMC
Other - Org Name:LOTT, SHEFFIELD ANESTHESIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:RADOSTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-768-1611
Mailing Address - Street 1:5253 DIJON DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4312
Mailing Address - Country:US
Mailing Address - Phone:225-768-1611
Mailing Address - Fax:225-768-1615
Practice Address - Street 1:5253 DIJON DR
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4312
Practice Address - Country:US
Practice Address - Phone:225-768-1611
Practice Address - Fax:225-768-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1942405Medicaid
LA5D328Medicare ID - Type Unspecified