Provider Demographics
NPI:1902671076
Name:LOUISIANA FOOT AND ANKLE SPECIALTY CENTER, LLC
Entity Type:Organization
Organization Name:LOUISIANA FOOT AND ANKLE SPECIALTY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:LINDOW
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:504-615-1656
Mailing Address - Street 1:1239 PATRIOT XING
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-7835
Mailing Address - Country:US
Mailing Address - Phone:225-290-7545
Mailing Address - Fax:225-659-8031
Practice Address - Street 1:1169 HIGHWAY 19 STE B
Practice Address - Street 2:
Practice Address - City:SLAUGHTER
Practice Address - State:LA
Practice Address - Zip Code:70777-3404
Practice Address - Country:US
Practice Address - Phone:504-615-1656
Practice Address - Fax:225-659-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty