Provider Demographics
NPI:1265457188
Name:DORGANT, LAUREN M (RD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:DORGANT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4442 BROWN
Mailing Address - Street 2:STE 1
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607
Mailing Address - Country:US
Mailing Address - Phone:337-475-8407
Mailing Address - Fax:337-475-8504
Practice Address - Street 1:1000 WALTERS ST
Practice Address - Street 2:LSU W O MOSS REGIONAL MEDICAL CENTER
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-4699
Practice Address - Country:US
Practice Address - Phone:337-475-8140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL963818133V00000X
LA1925133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered