LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER – NPI #1407808405
Internal Medicine

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER is a provider located in LAKE CHARLES, LA. NPPES has assigned the NPI number 1407808405 to LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER on May 17, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI data, there are 4 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RC0000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Cardiovascular Disease

The NPI profile was last updated on Mar 25, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER below.

NPI Profile for
LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER

NPI Number
1407808405
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER
Primary location
1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA 70601-8990
Phone: (337) 494-3278 Fax: (337) 494-3240
4 Other location(s):
122 W 4th St
Dequincy, LA 70633-3508
Phone: (337) 494-3278
Fax: (337) 494-3240
109 W 4th St
Deridder, LA 70634-4849
Phone: (337) 494-3278
Fax: (337) 494-3240
1322 Elton Rd Ste E
Jennings, LA 70546-4100
Phone: (337) 494-3278
Fax: (337) 494-3240
913 E Kent Dr
Sulphur, LA 70663-5007
Phone: (337) 494-3278
Fax: (337) 494-3240
Mailing address
PO BOX 122152, DEPT 2152 DEPT 2152
DALLAS, TX 75312-2152
Phone: (337) 494-2921 Fax: (337) 494-6523
Organization Subpart
Yes - LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER is subpart of another organization.
Authorized Official
DAWN JOHNSON-HATCHER
CFO
Phone: (337) 494-2094
Updated
Certification Date
Mar 25, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherRAILROAD MEDICARELACE9693
medicaidLA1948098
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RC0000X
- Internal Medicine / Cardiovascular Disease (Primary)
LA
208G00000X
- Thoracic Surgery (Cardiothoracic Vascular Surgery)
LA

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.