Jean Wedner Rousseau, MD | |
4140 Hollywood Avenue, Shreveport, LA 71109-7818 | |
(318) 621-9600 | |
(318) 621-0169 |
Full Name | Jean Wedner Rousseau |
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Gender | Male |
Speciality | General Practice |
Location | 4140 Hollywood Avenue, 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 |
---|---|---|---|
1750485900 | NPI | - | NPPES |
1334022 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 06203R (Louisiana) | Primary |
Entity Name | Pediatric Providers Of Louisiana |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548494578 PECOS PAC ID: 9830243138 Enrollment ID: O20090821000013 |
Mailing Address | Practice Location Address |
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Jean Wedner Rousseau, MD 4140 Hollywood Avenue, Shreveport, LA 71109-7818 Ph: (318) 621-9600 | Jean Wedner Rousseau, MD 4140 Hollywood Avenue, Shreveport, LA 71109-7818 Ph: (318) 621-9600 |
Pilar Sheplan Olsen, MD General Practice Medicare: Medicare Enrolled Practice Location: 510 E Stoner Ave, Shreveport, LA 71101 Phone: 318-990-3423 | |
Dr. Charles F. Sale, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 8001 Youree Dr., Suite 300, Shreveport, LA 71115 Phone: 318-212-3800 Fax: 318-212-3895 | |
Dr. Ezekiel J Wetzel, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 1501 Kings Hwy, Department Of Anesthesia, Shreveport, LA 71103 Phone: 318-675-5298 Fax: 318-675-6681 | |
Jenna Danielle Andre, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 6202 Kathy Ln, Shreveport, LA 71105 Phone: 816-590-6753 | |
Julana Monti, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 672 Bert Kouns Loop, Shreveport, LA 71118 Phone: 318-347-7290 Fax: 318-949-6861 | |
Dr. Alex Lev Glotser, M.D. General Practice Medicare: Not Enrolled in Medicare Practice Location: 1501 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-4147 | |
Dr. Natalia Luraguiz, General Practice Medicare: Accepting Medicare Assignments Practice Location: 1534 Elizabeth Ave Ste 401a, Shreveport, LA 71101 Phone: 318-431-8613 Fax: 318-314-2203 |