| Jared Gilmore Iii, MD | |
|
604 N Acadia Rd, Ste 409, Thibodaux, LA 70301-4897 | |
| (985) 449-4670 | |
| (985) 449-2598 |
| Full Name | Jared Gilmore Iii |
|---|---|
| Gender | Male |
| Speciality | Cardiovascular Disease (cardiology) |
| Experience | 37 Years |
| Location | 604 N Acadia Rd, Thibodaux, 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 |
|---|---|---|---|
| 1083685770 | NPI | - | NPPES |
| 1902560 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 020594 (Louisiana) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 020594 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Home Health Ctr Of Thibodaux | Thibodaux, LA | Home health agency |
| Thibodaux Regional Medical Center | Thibodaux, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Thibodaux Regional Network Development Corporation | 8224011754 | 138 |
| Entity Name | Louisiana State University School of Medicine in New Orleans Faculty G |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477582526 PECOS PAC ID: 0244136448 Enrollment ID: O20031209000661 |
| Entity Name | Thibodaux Regional Network Development Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285658310 PECOS PAC ID: 8224011754 Enrollment ID: O20040608000132 |
| Mailing Address | Practice Location Address |
|---|---|
| Jared Gilmore Iii, MD Po Box 5478, Ste 409, Thibodaux, LA 70302-5478 Ph: (985) 449-4670 | Jared Gilmore Iii, MD 604 N Acadia Rd, Ste 409, Thibodaux, LA 70301-4897 Ph: (985) 449-4670 |
Tommy Lester Fudge, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Not Enrolled in Medicare Practice Location: 604 N Acadia Rd, Suite 409, Thibodaux, LA 70301 Phone: 985-449-4670 Fax: 985-449-2598 |