Green Clinic Llc | |
1200 S Farmerville St, Ruston, LA 71270-5941 | |
(318) 255-3690 | |
Not Available |
Full Name | Green Clinic Llc |
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Type | Facility |
Speciality | Family Medicine |
Location | 1200 S Farmerville St, Ruston, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831178755 | NPI | - | NPPES |
1006858 | Medicaid | LA | |
========= | Other | LA | BCBS GROUP |
CS0281 | Other | LA | RR MEDICARE GROUP |
06185 | Other | LA | BCBS GROUP |
Provider Name | Warren John Green |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1174546386 PECOS PAC ID: 7911893821 Enrollment ID: I20041029000004 |
Provider Name | Michael S Phillips |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154391431 PECOS PAC ID: 2062449911 Enrollment ID: I20050721000738 |
Provider Name | John Hebert |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1538100805 PECOS PAC ID: 4688690340 Enrollment ID: I20051021000300 |
Provider Name | Jeffrey Weeks |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1780654459 PECOS PAC ID: 6406873660 Enrollment ID: I20051027000058 |
Provider Name | Derek R Mcclusky |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1184694903 PECOS PAC ID: 8426077470 Enrollment ID: I20051118000239 |
Provider Name | David C Osafo |
---|---|
Provider Type | Practitioner - Hematology/oncology |
Provider Identifiers | NPI Number: 1467489542 PECOS PAC ID: 8022012137 Enrollment ID: I20060901000301 |
Provider Name | Kerry Byrnes |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1982787099 PECOS PAC ID: 2668574914 Enrollment ID: I20070216000567 |
Provider Name | Elvin Gregory Tubre |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1336108877 PECOS PAC ID: 8123015989 Enrollment ID: I20071217000732 |
Provider Name | Landon C Smith |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1790783322 PECOS PAC ID: 5294894499 Enrollment ID: I20081103000391 |
Provider Name | Kiley E Stephenson |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1215187232 PECOS PAC ID: 2567525389 Enrollment ID: I20090106000017 |
Provider Name | William M Wilder |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1730120312 PECOS PAC ID: 6406872134 Enrollment ID: I20090520000335 |
Provider Name | William Sanders |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093921066 PECOS PAC ID: 1052465705 Enrollment ID: I20090815000042 |
Provider Name | Edie Lemley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891711883 PECOS PAC ID: 1355496423 Enrollment ID: I20090826000544 |
Provider Name | James Mcwhorter |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1467422295 PECOS PAC ID: 5890875421 Enrollment ID: I20100206000220 |
Provider Name | George Smith |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1164492484 PECOS PAC ID: 0143300772 Enrollment ID: I20100210000374 |
Provider Name | Candace Moak |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1588634273 PECOS PAC ID: 4981784519 Enrollment ID: I20100211000373 |
Provider Name | William Smith |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1992776231 PECOS PAC ID: 6406936038 Enrollment ID: I20100215000272 |
Provider Name | Tonya Slusher |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1518937259 PECOS PAC ID: 9133209760 Enrollment ID: I20100301000887 |
Provider Name | Michael Ehrlich |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1780654186 PECOS PAC ID: 7517047145 Enrollment ID: I20100302000052 |
Provider Name | Mark Blackwelder |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1245200880 PECOS PAC ID: 0345320974 Enrollment ID: I20100303001150 |
Provider Name | Tarek M Nammour |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1689644379 PECOS PAC ID: 8820907462 Enrollment ID: I20100315001012 |
Provider Name | Gary Ellis Luffey |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1760452650 PECOS PAC ID: 0749207488 Enrollment ID: I20100315001015 |
Provider Name | Thomas Smith |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1801867130 PECOS PAC ID: 5597845123 Enrollment ID: I20100317000369 |
Provider Name | Greene S Butler |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1619947629 PECOS PAC ID: 8022083971 Enrollment ID: I20100330001374 |
Provider Name | Johnathan C Baines |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1679769889 PECOS PAC ID: 5193856755 Enrollment ID: I20100625000112 |
Provider Name | Raymond D Germany Jr |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1649275116 PECOS PAC ID: 8628976255 Enrollment ID: I20100714000499 |
Provider Name | Rochelle A Robicheaux |
---|---|
Provider Type | Practitioner - Rheumatology |
Provider Identifiers | NPI Number: 1750575890 PECOS PAC ID: 2365539863 Enrollment ID: I20100812000154 |
Provider Name | Joshua Mandrell |
---|---|
Provider Type | Practitioner - Dermatology |
Provider Identifiers | NPI Number: 1770781650 PECOS PAC ID: 0648440107 Enrollment ID: I20110819000431 |
Provider Name | Shane M. Mcvay |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700222379 PECOS PAC ID: 5991946733 Enrollment ID: I20130722000064 |
Provider Name | Nancy Bourn Adkins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083960587 PECOS PAC ID: 3678718780 Enrollment ID: I20130916000443 |
Provider Name | Stacey Heckford Spears |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245670314 PECOS PAC ID: 5395989875 Enrollment ID: I20130924000234 |
Provider Name | Kenneth P Metoyer |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265692156 PECOS PAC ID: 1759518343 Enrollment ID: I20131205000196 |
Provider Name | Ashley Walpole |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164804936 PECOS PAC ID: 9638485394 Enrollment ID: I20150826002274 |
Provider Name | Cleo Deason |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881077808 PECOS PAC ID: 8123334398 Enrollment ID: I20150902002006 |
Provider Name | Navneet Sharma |
---|---|
Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1811286099 PECOS PAC ID: 0547577934 Enrollment ID: I20150917000807 |
Provider Name | Marlene Daher |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1952371965 PECOS PAC ID: 6608956230 Enrollment ID: I20160203000883 |
Provider Name | Robin Renee Hart Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346612173 PECOS PAC ID: 4880998046 Enrollment ID: I20160209000215 |
Provider Name | Robert Railey Garrett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992162622 PECOS PAC ID: 8820392681 Enrollment ID: I20160215002472 |
Provider Name | Hollie A Knapp |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710438668 PECOS PAC ID: 9335426105 Enrollment ID: I20170503002075 |
Provider Name | Jacob Elidge Enterkin |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1306043096 PECOS PAC ID: 2769626530 Enrollment ID: I20180123003151 |
Provider Name | Lisa Marie Farris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700385622 PECOS PAC ID: 8921369604 Enrollment ID: I20180220001480 |
Provider Name | Erin Lancaster |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104399393 PECOS PAC ID: 6901144500 Enrollment ID: I20190206001062 |
Provider Name | Whitney M Rust |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477048874 PECOS PAC ID: 0941638548 Enrollment ID: I20200313001195 |
Provider Name | Kristina D Barber |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043801954 PECOS PAC ID: 2163838145 Enrollment ID: I20210317002215 |
Provider Name | Hunter Thomas Christy |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1699162206 PECOS PAC ID: 5698073211 Enrollment ID: I20210616002306 |
Provider Name | Haley Jones |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689305260 PECOS PAC ID: 8123408390 Enrollment ID: I20220706000449 |
Provider Name | Hannah Rose Rugg |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1831758630 PECOS PAC ID: 0244662161 Enrollment ID: I20220726000254 |
Provider Name | Thomas Iii Block |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1265096390 PECOS PAC ID: 9537490883 Enrollment ID: I20240521001258 |
Provider Name | Kristina Moore Stanfield |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1639670458 PECOS PAC ID: 6709138928 Enrollment ID: I20240709004917 |
Provider Name | Cody Blackwelder |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1548824873 PECOS PAC ID: 1153716253 Enrollment ID: I20240710000011 |
Provider Name | Caleb Benjamin Stanfield |
---|---|
Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1497252225 PECOS PAC ID: 6204187552 Enrollment ID: I20240823001369 |
Provider Name | Andrew Joseph Smith |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1033606058 PECOS PAC ID: 4688922164 Enrollment ID: I20240823001524 |
Mailing Address | Practice Location Address |
---|---|
Green Clinic Llc 1200 S Farmerville St, Ruston, LA 71270-5941 Ph: (318) 255-3690 | Green Clinic Llc 1200 S Farmerville St, Ruston, LA 71270-5941 Ph: (318) 255-3690 |