Provider Demographics
NPI:1407034051
Name:RANDALL D. LEA, M.D. PC
Entity Type:Organization
Organization Name:RANDALL D. LEA, M.D. PC
Other - Org Name:CENTER OF ORTHOPAEDIC CARE & EVALUATIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-754-8888
Mailing Address - Street 1:14635 S HARRELL'S FERRY ROAD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2961
Mailing Address - Country:US
Mailing Address - Phone:225-754-8888
Mailing Address - Fax:225-751-5847
Practice Address - Street 1:14635 S HARRELL'S FERRY ROAD
Practice Address - Street 2:SUITE 3A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2961
Practice Address - Country:US
Practice Address - Phone:225-754-8888
Practice Address - Fax:225-751-5847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015413207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty