Dr Mary Coenen Raven, MD | |
4950 Essen Ln Ste 503, Baton Rouge, LA 70809-3738 | |
(225) 765-1737 | |
(225) 765-1842 |
Full Name | Dr Mary Coenen Raven |
---|---|
Gender | Female |
Speciality | Internal Medicine |
Experience | 20 Years |
Location | 4950 Essen Ln Ste 503, Baton Rouge, Louisiana |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427249366 | NPI | - | NPPES |
05823364 | Medicaid | MS | |
1066991 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 200349 (Louisiana) | Primary |
207RH0002X | Internal Medicine - Hospice And Palliative Medicine | 200349 (Louisiana) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Our Lady Of The Lake Regional Medical Center | Baton rouge, LA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Our Lady Of The Lake Physician Group Llc | 4587849781 | 521 |
Entity Name | Our Lady Of The Lake Physician Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377 |
Mailing Address | Practice Location Address |
---|---|
Dr Mary Coenen Raven, MD 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (225) 526-0177 | Dr Mary Coenen Raven, MD 4950 Essen Ln Ste 503, Baton Rouge, LA 70809-3738 Ph: (225) 765-1737 |
Dr. Jennifer L Rippon, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 7777 Hennessy Blvd Ste 409, Baton Rouge, LA 70808 Phone: 225-765-5864 Fax: 225-765-2013 | |
Gregory Fusilier, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 9103 Jefferson Hwy, Baton Rouge, LA 70809 Phone: 225-927-1190 Fax: 225-927-0988 | |
Dr. Yolanda Maria O'rourke, Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 7968 Essen Park, Baton Rouge, LA 70809 Phone: 225-761-6700 Fax: 225-761-6760 | |
Patricia D. Whatley, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 7373 Perkins Rd, Attn: Dee / Administration, Baton Rouge, LA 70808 Phone: 225-769-4044 | |
Frederick Cerise, Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 3810 W Lakeshore Dr, Baton Rouge, LA 70808 Phone: 225-578-8886 | |
Nicholas Kyle Baldwin, Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 9103 Jefferson Hwy, Baton Rouge, LA 70809 Phone: 225-927-1190 | |
Dr. Jon Richard Jackson, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5000 Hennessy Blvd, Baton Rouge, LA 70808 Phone: 225-765-4050 Fax: 225-765-4046 |