Provider Demographics
NPI:1588674790
Name:LAKE CHARLES ANESTHESIOLOGY, APMC
Entity Type:Organization
Organization Name:LAKE CHARLES ANESTHESIOLOGY, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEMOINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-478-0511
Mailing Address - Street 1:424 W MCNEESE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-5547
Mailing Address - Country:US
Mailing Address - Phone:337-478-0511
Mailing Address - Fax:337-478-5644
Practice Address - Street 1:424 W MCNEESE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5547
Practice Address - Country:US
Practice Address - Phone:337-478-0511
Practice Address - Fax:337-478-5644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1792781Medicaid
LA5B638Medicare PIN