MICHELLE CLARK DYESS

OUR LADY OF THE LAKE PHYSICIAN GROUP LLC

Dr MICHELLE CLARK DYESS is a female medical professional, specializing in Physician Assistant. She graduated in 2014.

Contact

OUR LADY OF THE LAKE PHYSICIAN GROUP LLC

5439 AIRLINE HWY
BATON ROUGE
LA
708051712

Tel: 2253584853

MICHELLE CLARK DYESS Information

Npi 1609276161
Pac Id 8729349105
Professional Enrollment Id I20180227001747
Last Name DYESS
First Name MICHELLE
Middle Name CLARK
Suffix
Gender F
Credential
Medical School Name OTHER
Graduation Year 2014
Primary Specialty PHYSICIAN ASSISTANT
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name OUR LADY OF THE LAKE PHYSICIAN GROUP LLC
Group Practice Pac Id 4587849781
Number Of Group Practice Members 439
Line 1 Street Address 5439 AIRLINE HWY
Line 2 Street Address
Marker Of Address Line 2 Suppression
City BATON ROUGE
State LA
Zip Code 708051712
Phone Number 2253584853
Hospital Affiliation Ccn 1 190064
Hospital Affiliation Lbn 1 OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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