Provider Demographics
NPI:1265754758
Name:DOCTORS HOSPITAL @ DEER CREEK, LLC
Entity type:Organization
Organization Name:DOCTORS HOSPITAL @ DEER CREEK, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-392-5088
Mailing Address - Street 1:PO BOX 1391
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-1496
Mailing Address - Country:US
Mailing Address - Phone:337-392-5088
Mailing Address - Fax:337-392-4982
Practice Address - Street 1:815 S 10TH ST
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-4611
Practice Address - Country:US
Practice Address - Phone:337-392-5088
Practice Address - Fax:337-392-4982
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOCTORS HOSPITAL @ DEER CREEK, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPENDINGMedicare Oscar/Certification