OrganizationActive
Lakeside Medical Wellness Clinic
NPI 1407147234 · Clinic/Center · Sulphur, LA
Lakeside Medical Wellness Clinic is a Clinic/Center organization in Sulphur, LA (NPI 1407147234).
Provider details
- NPI number
- 1407147234
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Stacy Kirkum, Administrator(337) 625-5050
- License
- MD14484R (LA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1908 Maplewood Dr
Suite B
Sulphur, LA 70663-6000
Phone: (337) 625-5050
Fax: (337) 625-6726
Street-level locationGet directions
Mailing address
1908 Maplewood Dr
Sulphur, LA 70663-6000
Registry dates
- Enumerated
- 2011-04-27
- Last updated
- 2011-04-27
Frequently asked questions
- What is Lakeside Medical Wellness Clinic's NPI number?
- Lakeside Medical Wellness Clinic's National Provider Identifier (NPI) is 1407147234, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lakeside Medical Wellness Clinic?
- Lakeside Medical Wellness Clinic is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Lakeside Medical Wellness Clinic located?
- Lakeside Medical Wellness Clinic's practice location on file with NPPES is 1908 Maplewood Dr, Sulphur, LA 70663-6000.
- What is Lakeside Medical Wellness Clinic's phone number?
- The practice phone number listed in the NPPES registry for Lakeside Medical Wellness Clinic is (337) 625-5050.
- Who is the authorized official for Lakeside Medical Wellness Clinic?
- The authorized official listed on Lakeside Medical Wellness Clinic's NPPES record is Stacy Kirkum, Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lakeside Medical Wellness Clinic's NPI active?
- Yes — Lakeside Medical Wellness Clinic's NPI (1407147234) is active in the NPPES registry as of the last update on 2011-04-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.