Provider Demographics
NPI:1235417064
Name:NORTH OAKS PHYSICIAN GROUP, LLC
Entity Type:Organization
Organization Name:NORTH OAKS PHYSICIAN GROUP, LLC
Other - Org Name:NORTH OAKS ORTHOPEDIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. V.P. / C.F.O.
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-230-6603
Mailing Address - Street 1:PO BOX 3087
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-3087
Mailing Address - Country:US
Mailing Address - Phone:985-370-7853
Mailing Address - Fax:985-370-7409
Practice Address - Street 1:15813 PAUL VEGA MD DR
Practice Address - Street 2:SUITE 100
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1495
Practice Address - Country:US
Practice Address - Phone:985-230-2663
Practice Address - Fax:985-230-2665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA000261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1447587Medicaid
LA1447587Medicaid
LA6719110002Medicare NSC
LA5D628Medicare PIN