| Jessica Anne Wilden, MD | |
|
2551 Greenwood Rd Ste 320, Shreveport, LA 71103-3989 | |
| (182) 127-1763 | |
| (318) 212-8186 |
| Full Name | Jessica Anne Wilden |
|---|---|
| Gender | Female |
| Speciality | Neurological Surgery |
| Location | 2551 Greenwood Rd Ste 320, 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 |
|---|---|---|---|
| 1962565127 | NPI | - | NPPES |
| 2342053 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207T00000X | Neurological Surgery | MT186916 (Pennsylvania) | Secondary |
| 207T00000X | Neurological Surgery | MD.206396 (Louisiana) | Primary |
| Entity Name | Wk Tri-state Neurosurgery Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538513429 PECOS PAC ID: 7416256771 Enrollment ID: O20160509001434 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Anne Wilden, MD 2551 Greenwood Rd Ste 320, Shreveport, LA 71103-3989 Ph: (318) 212-8176 | Jessica Anne Wilden, MD 2551 Greenwood Rd Ste 320, Shreveport, LA 71103-3989 Ph: (182) 127-1763 |
Keisha Roichelle Bonyfield, APRN Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1501 Kings Hwy, Shreveport, LA 71103 Phone: 318-795-2638 | |
Philip Andrew Utter, M.D. Neurological Surgery Medicare: May Accept Medicare Assignments Practice Location: 1500 Line Avenue, Ste 200, Shreveport, LA 71101 Phone: 318-629-5555 Fax: 318-629-5556 | |
Anthony Hunkyun Sin, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1501 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-5000 | |
Jorge Martinez-leyva, M.D. Neurological Surgery Medicare: Medicare Enrolled Practice Location: 8001 Youree Dr, Suite 850, Shreveport, LA 71115 Phone: 318-424-2623 Fax: 318-227-1357 | |
Hugo Humberto Cuellar - Saenz, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Dr. Peter Gravel Campbell, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1500 Line Ave Ste 200, Shreveport, LA 71101 Phone: 318-629-5555 Fax: 318-629-5556 | |
Bharat Guthikonda, Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1501 Kings Hwy, Department Of Neurosurgery, Shreveport, LA 71103 Phone: 318-813-1555 Fax: 318-813-2491 |