Provider Demographics
NPI:1497935795
Name:HOSPITAL SPECIALISTS, LLC
Entity Type:Organization
Organization Name:HOSPITAL SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:YOUNGBLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-868-3737
Mailing Address - Street 1:PO BOX 4335
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-4335
Mailing Address - Country:US
Mailing Address - Phone:985-868-3737
Mailing Address - Fax:985-873-9997
Practice Address - Street 1:8120 MAIN ST
Practice Address - Street 2:SUITE 403
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-3403
Practice Address - Country:US
Practice Address - Phone:985-868-3737
Practice Address - Fax:985-873-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200196207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1626970Medicaid
LA1626970Medicaid
LA5BC93Medicare PIN