Dr Willard F Washburne, MD | |
1455 E Bert Kouns Loop, Shreveport, LA 71105-5634 | |
(318) 798-4544 | |
(318) 798-4557 |
Full Name | Dr Willard F Washburne |
---|---|
Gender | Male |
Speciality | Allergy & Immunology |
Location | 1455 E Bert Kouns Loop, Shreveport, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982608659 | NPI | - | NPPES |
1053315846 | Other | LA | GROUP NPI NUMBER |
P00049384 | Other | LA | RAILROAD MEDICARE |
051692402 | Other | TX | TEXAS MEDICAID NUMBER |
1141933 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207K00000X | Allergy & Immunology | 012342 (Louisiana) | Primary |
Entity Name | Louisiana State University Health Sciences Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417992249 PECOS PAC ID: 6103730908 Enrollment ID: O20031208000275 |
Entity Name | Lsu Health Sciences Center Shreveport Faculty Group Practice |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013374222 PECOS PAC ID: 4082902721 Enrollment ID: O20161012000307 |
Mailing Address | Practice Location Address |
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Dr Willard F Washburne, MD 1455 E Bert Kouns Loop, Shreveport, LA 71105-5634 Ph: (318) 798-4544 | Dr Willard F Washburne, MD 1455 E Bert Kouns Loop, Shreveport, LA 71105-5634 Ph: (318) 798-4544 |
Ioannis A. Moissidis, MD Allergy & Immunology Medicare: Not Enrolled in Medicare Practice Location: 850 Olive St, Suite B, Shreveport, LA 71104 Phone: 318-221-3584 Fax: 318-227-9094 | |
David A Kaufman, M.D. Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 463 Ashley Ridge Blvd, Ste 100, Shreveport, LA 71106 Phone: 318-221-3584 Fax: 318-227-9094 | |
Dr. Lori R Johnson, MD Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 1455 E Bert Kouns Loop, Shreveport, LA 71105 Phone: 318-798-4573 Fax: 318-798-4651 | |
Dr. Steven C Whited, MD Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 1455 E Bert Kouns Loop, Shreveport, LA 71105 Phone: 318-798-4573 Fax: 318-798-4651 | |
Gonzalo Alvarez Del Real, MD Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 1455 E Bert Kouns Industrial Loop # 108, Shreveport, LA 71105 Phone: 318-798-4544 Fax: 318-798-4557 | |
Dr. Caroline Virginia Caperton, M.D., M.S.P.H. Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 2530 Bert Kouns Industrial Loop Ste 112, Shreveport, LA 71118 Phone: 318-212-4824 |