Individual provider · NPI-1

Johnny Ray Biddle Jr., M.D.

Family Medicine · Lake Charles, LA

NPI number1902010952
StatusActive
Last updated in NPPESNov 10, 2015

Details

NPI
1902010952
Entity type
Individual (NPI-1)
Name
Johnny Ray Biddle Jr.
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
May 9, 2007
Last updated
Nov 10, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine05629RLAYes
174400000X Specialist05629RLA
208D00000X General Practice05629RLA

Practice location

3608 Kirkman St
Lake Charles, LA 70607-3006

Phone 337-936-6893 · Fax 337-564-0931

Mailing address

630 W Prien Lake Rd
B 210
Lake Charles, LA 70601-0700

Phone 337-936-6893 · Fax 337-564-0931

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Family Medicine providers in Lake Charles, LA