Dr Kirk Anthony Grantham, MD | |
2530 Bert Kouns Loop, Suite 138, Shreveport, LA 71118-3132 | |
(318) 588-4726 | |
(318) 900-7828 |
Full Name | Dr Kirk Anthony Grantham |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 15 Years |
Location | 2530 Bert Kouns Loop, Shreveport, Louisiana |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023241403 | NPI | - | NPPES |
193488001 | Other | AR | AR MEDICAID |
2303732 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | TRN 14355 (Florida) | Secondary |
207Q00000X | Family Medicine | MD.205467 (Louisiana) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Wound Care Contractors Llc | 5991139644 | 5 |
Entity Name | Wk Hyperbaric & Wound Care Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417100264 PECOS PAC ID: 4183787799 Enrollment ID: O20090108000169 |
Entity Name | Wk Bossier Hyperbaric And Wound Care Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508295338 PECOS PAC ID: 7315176898 Enrollment ID: O20140203000731 |
Entity Name | Wound Care Contractors Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548818735 PECOS PAC ID: 5991139644 Enrollment ID: O20200106000906 |
Mailing Address | Practice Location Address |
---|---|
Dr Kirk Anthony Grantham, MD Po Box 1264, Benton, LA 71006-1264 Ph: (318) 588-4726 | Dr Kirk Anthony Grantham, MD 2530 Bert Kouns Loop, Suite 138, Shreveport, LA 71118-3132 Ph: (318) 588-4726 |
Ratnam Baby Nagalla, M.D Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 870 Olive St, Shreveport, LA 71104 Phone: 318-629-0480 Fax: 318-629-0483 | |
David Juston Colvin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8383 Millicent Way, Shreveport, LA 71115 Phone: 318-797-6661 Fax: 318-795-8512 | |
Susan Michelle Self, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8001 Youree Dr, Suite 540, Shreveport, LA 71115 Phone: 318-212-3810 Fax: 318-212-3815 | |
Jaya R Mcsharma, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 700 Texas St Ste 101, Shreveport, LA 71101 Phone: 318-777-6843 Fax: 318-625-5520 | |
Ayesha Tabassom, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 Fax: 318-629-4833 | |
David Henry, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 7813 Youree Dr, Shreveport, LA 71105 Phone: 318-212-3830 Fax: 318-212-3835 |