| Dr Lori A Mcbride, MD | |
| 
					7777 Hennessy Blvd Ste 306, Baton Rouge, LA 70808-4365  | |
| (225) 765-6834 | |
| (225) 765-5543 | 
| Full Name | Dr Lori A Mcbride | 
|---|---|
| Gender | Female | 
| Speciality | Neurological Surgery | 
| Location | 7777 Hennessy Blvd Ste 306, Baton Rouge, Louisiana | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1730239708 | NPI | - | NPPES | 
| 1622320 | Medicaid | LA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207T00000X | Neurological Surgery | 200135 (Louisiana) | Primary | 
| Entity Name | Our Lady Of The Lake Physician Group Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Lori A Mcbride, MD 5959 S Sherwood Forest Blvd # A11, Baton Rouge, LA 70816-6038 Ph: (225) 526-0013  | Dr Lori A Mcbride, MD 7777 Hennessy Blvd Ste 306, Baton Rouge, LA 70808-4365 Ph: (225) 765-6834  | 
Scott W. Soleau, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 10101 Park Rowe Ave, Suite 200, Baton Rouge, LA 70810 Phone: 225-769-2200 Fax: 225-768-2185  | |
Thomas B Flynn, M.D. Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 10101 Park Rowe Ave, Suite 200, Baton Rouge, LA 70810 Phone: 225-769-2200 Fax: 225-768-2185  | |
Brandon Gerard Gaynor,  Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 10101 Park Rowe Ave Ste 200, Baton Rouge, LA 70810 Phone: 225-769-2200 Fax: 225-768-2185  | |
John R Clifford, MD Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 10101 Park Rowe Ave, Suite 200, Baton Rouge, LA 70810 Phone: 225-769-2200 Fax: 225-768-2185  | |
Dr. Marvin Dementreous Clifton, MD Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 4884 Constitution Ave, Ste 1e, Baton Rouge, LA 70808 Phone: 225-923-1621 Fax: 225-923-1623  | |
Dr. Anthony S Ioppolo, MD Neurological Surgery Medicare: Medicare Enrolled Practice Location: 7777 Hennessy Blvd Plaza 1, 709, Baton Rouge, LA 70808 Phone: 225-757-1960 Fax: 225-757-1959  | |
Dr. Garrett Venable, M.D. Neurological Surgery Medicare: Medicare Enrolled Practice Location: 10101 Park Rowe Ave, Baton Rouge, LA 70810 Phone: 225-768-2164  |