Provider Demographics
NPI:1215290796
Name:NORTH OAKS PHYSICIAN GROUP, LLC
Entity type:Organization
Organization Name:NORTH OAKS PHYSICIAN GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. V.P. / C.F.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-230-6655
Mailing Address - Street 1:PO BOX 1608
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-1608
Mailing Address - Country:US
Mailing Address - Phone:985-542-9155
Mailing Address - Fax:985-542-9133
Practice Address - Street 1:42401 PELICAN PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-2405
Practice Address - Country:US
Practice Address - Phone:985-542-9155
Practice Address - Fax:985-542-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1447587Medicaid
LA5DY20Medicare PIN
LA277973Medicare PIN