Dwayne Jeter Sr, is a
Case Manager/care Coordinator based in Shreveport, Louisiana. Dwayne Jeter Sr is licensed to practice in * (Not Available) (license number ) and his current practice location is
7505 Pines Rd Ste 1200i, Shreveport, Louisiana. He can be reached at his office (for appointments etc.) via phone at
(318) 716-1707.
NPI number for Dwayne Jeter Sr is 1487100194 and his current mailing address is Po Box 104, Elysian Fields, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1487100194.
Healthcare Provider's Profile
Full Name | Dwayne Jeter Sr |
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Gender | Male |
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Speciality | Case Manager/care Coordinator |
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Location | 7505 Pines Rd Ste 1200i, Shreveport, Louisiana |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1487100194
- Provider Enumeration Date: 09/01/2016
- Last Update Date: 12/05/2018
Medical Identifiers
Medical identifiers for Dwayne Jeter Sr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487100194 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dwayne Jeter Sr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dwayne Jeter Sr, Po Box 104, Elysian Fields, TX 75642-0104 Ph: (903) 503-3111 | Dwayne Jeter Sr, 7505 Pines Rd Ste 1200i, Shreveport, LA 71129-3900 Ph: (318) 716-1707 |
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