Dr Bonita H Dyess, MD | |
3401 Magnolia Cv, Monroe, LA 71203-2375 | |
(318) 325-6311 | |
(318) 361-9805 |
Full Name | Dr Bonita H Dyess |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 3401 Magnolia Cv, Monroe, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902899602 | NPI | - | NPPES |
1304875 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 013370 (Louisiana) | Primary |
Entity Name | Affinity Health Group, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023291226 PECOS PAC ID: 9335226547 Enrollment ID: O20080411000088 |
Mailing Address | Practice Location Address |
---|---|
Dr Bonita H Dyess, MD 5959 S Sherwood Forest Blvd Ste 355, Baton Rouge, LA 70816-6038 Ph: () - | Dr Bonita H Dyess, MD 3401 Magnolia Cv, Monroe, LA 71203-2375 Ph: (318) 325-6311 |
Barrington L Ricks, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 920 Oliver Rd, Suite 3, Monroe, LA 71201 Phone: 318-323-8824 Fax: 318-323-8823 | |
Dr. Taylor Brooke Shepherd, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2600 Tower Dr Ste 214, Monroe, LA 71201 Phone: 318-323-8824 | |
Nancy L Zukowski, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3401 Magnolia Cv, Monroe, LA 71203 Phone: 318-325-6311 Fax: 318-361-9805 | |
Nour Khalid Abu Saleh, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2915 Betin Ave, Monroe, LA 71201 Phone: 318-651-9945 Fax: 318-322-5141 | |
Umashankar Kandasamy, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 4864 Jackson St, Monroe, LA 71202 Phone: 318-330-7000 | |
Dr. Martin C Young, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2915 Betin Ave, Monroe, LA 71201 Phone: 318-561-9945 | |
Gary E Stanley, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 920 Oliver Rd, Suite 3, Monroe, LA 71201 Phone: 318-323-8824 Fax: 318-323-8823 |