Brandon Lane Phillips, MD | |
300 Pavilion Rd, West Monroe, LA 71292-9470 | |
(318) 323-1100 | |
Not Available |
Full Name | Brandon Lane Phillips |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Cardiology |
Location | 300 Pavilion Rd, West 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 |
---|---|---|---|
1881893808 | NPI | - | NPPES |
09731876 | Medicaid | MS | |
2430718 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0202X | Pediatrics - Pediatric Cardiology | N5944 (Texas) | Secondary |
2080P0202X | Pediatrics - Pediatric Cardiology | 303412 (Louisiana) | Primary |
Entity Name | Driscoll Physicians Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528015096 PECOS PAC ID: 4587577747 Enrollment ID: O20031112000570 |
Mailing Address | Practice Location Address |
---|---|
Brandon Lane Phillips, MD 1514 Jefferson Hwy, New Orleans, LA 70121-2429 Ph: (504) 842-4000 | Brandon Lane Phillips, MD 300 Pavilion Rd, West Monroe, LA 71292-9470 Ph: (318) 323-1100 |
Marilyn Grisham Bivens, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 104 Contempo Ave, West Monroe, LA 71291 Phone: 318-329-8181 Fax: 318-329-8183 | |
Dr. Cynthia Petrus Bimle, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 107 Contempo, Suite A, West Monroe, LA 71291 Phone: 318-388-5030 | |
Terry Dean King, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 300 Pavilion Rd, West Monroe, LA 71292 Phone: 318-323-1100 Fax: 318-323-1161 | |
Mrs. Shelly C Mccormick, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 503 Mcmillan Rd, West Monroe, LA 71291 Phone: 318-329-8310 Fax: 318-329-8313 | |
Kadie Bimle Frost, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 107 Contempo Ave., Suite 2, West Monroe, LA 71291 Phone: 318-324-0111 Fax: 318-324-9679 | |
Lyndall Saadat, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 102 Thomas Rd, West Monroe, LA 71291 Phone: 318-812-0168 Fax: 318-812-0170 |