OrganizationActive
Executive Medical Clinic of Lake Charles
NPI 1982126520 · Family Medicine Physician · Lake Charles, LA
Provider details
- NPI number
- 1982126520
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Melissa Lebrun, President(225) 939-0050
- License
- AP06496 (LA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 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
765 East Bayou Pines Drive
Lake Charles, LA 70601-5690
Phone: (337) 210-1260
Street-level locationGet directions
Mailing address
765 East Bayou Pines Drive
Lake Charles, LA 70601-5690
Registry dates
- Enumerated
- 2017-07-14
- Last updated
- 2022-09-19
- Certified
- 2022-09-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.