OLOL PHYSICIAN SURGICAL SPECIALTY
NPI 1184671455
Internal Medicine - Hematology & Oncology in Baton Rouge, LA

Active since May 30, 2006CLIA 19D2189683 · Waiver
4950 ESSEN LN, BATON ROUGE, LA 70809(225) 767-1311(225) 767-1335 Get Directions Write a Review

NPPES record last updated: February 20, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Olol Physician Surgical Specialty NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLOL PHYSICIAN SURGICAL SPECIALTY (NPI 1184671455) is a healthcare organization registered as a hematology & oncology in Baton Rouge, Louisiana and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through August 3, 2026 and lists Tamara White, Director Of Business Services, as its authorized official.

NPPES Registry Identity

NPI1184671455
Entity TypeOrganization
Primary Taxonomy207RH0003X
Legal Business NameOUR LADY OF THE LAKE PHYSICIAN GROUP LLC
Location Address4950 ESSEN LNBaton Rouge, LA 70809-3738
Mailing Address8415 Goodwood Blvd, Ste 105Baton Rouge, LA 70806-7851 · (225) 765-5727 · Fax (225) 765-4278
Fax(225) 767-1335
Organization SubpartNo
Authorized OfficialTamara WhiteDirector Of Business Services · (225) 765-5727
Enumeration DateMay 30, 2006
Last NPPES UpdateFebruary 20, 2013
NPI 1184671455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Also ListedSurgeryTaxonomy 208600000X
Also ListedSurgery · Trauma SurgeryTaxonomy 2086S0127X
Also ListedColon & Rectal SurgeryTaxonomy 208C00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
4950 ESSEN LN, Baton Rouge, LA 70809

Other Names 1

Doing Business AsOlol Physician Surgical Specialty

Other Identifiers 3

Medicaid1447218LA
Medicare PIN5CR65LA
Medicaid05684711MS

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 19D2189683

Our Lady Of The Lake Physician Group - Staring · Baton Rouge, LA
Active · expires Aug 3, 2026
CLIA Number19D2189683
Laboratory TypePhysician Office
Certificate Effective DateAugust 4, 2024
Certificate Expiration DateAugust 3, 2026
Laboratory DirectorJohn Fraiche
Laboratory Phone(227) 765-4407
Laboratory LocationOur Lady Of The Lake Physician Group - Staring8119 Picardy Ave, Suite B, Baton Rouge, LA 70809
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Anesthetist, Certified Registered
4950 ESSEN LN, REGIONAL EYE SURGERY CENTER
BATON ROUGE, LA 70809
Nurse Anesthetist, Certified Registered
4950 ESSEN LN, REGIONAL EYE SURGERY CENTER
BATON ROUGE, LA 70809
Nurse Anesthetist, Certified Registered
4950 ESSEN LN, REGIONAL EYE SURGERY CENTER
BATON ROUGE, LA 70809
Nurse Anesthetist, Certified Registered
4950 ESSEN LN, REGIONAL EYE SURGERY CENTER
BATON ROUGE, LA 70809
Nurse Anesthetist, Certified Registered
4950 ESSEN LN, REGIONAL EYE SURGERY CENTER
BATON ROUGE, LA 70809
Nurse Anesthetist, Certified Registered
4950 ESSEN LN, REGIONAL EYE SURGERY CENTER
BATON ROUGE, LA 70809
Nurse Anesthetist, Certified Registered
4950 ESSEN LN, REGIONAL EYE SURGERY CENTER
BATON ROUGE, LA 70809
Internal Medicine (Hematology & Oncology)
4950 ESSEN LN
BATON ROUGE, LA 70809

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1184671455, enumerated as an "organization" on May 30, 2006.

The provider is located at 4950 ESSEN LN BATON ROUGE, LA 70809 and the phone number is (225) 767-1311.

Internal Medicine with taxonomy code 207RH0003X and a focus in Hematology & Oncology.

The provider might be accepting Accepts: AmeriHealth Caritas Next, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.