Provider Demographics
NPI:1366684201
Name:OCEANS PHYSICIANS GROUP LLC
Entity Type:Organization
Organization Name:OCEANS PHYSICIANS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-721-1900
Mailing Address - Street 1:127 W BROAD ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-4291
Mailing Address - Country:US
Mailing Address - Phone:337-721-1900
Mailing Address - Fax:337-721-1996
Practice Address - Street 1:1310 HEATHER DR
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-7714
Practice Address - Country:US
Practice Address - Phone:337-948-8820
Practice Address - Fax:347-948-8821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty