Mr Ronnie Self Ii, | |
1990 Industrial Blvd, Houma, LA 70363-7055 | |
(985) 868-9300 | |
(985) 851-0053 |
Full Name | Mr Ronnie Self Ii |
---|---|
Gender | Male |
Speciality | Pathology |
Experience | 15 Years |
Location | 1990 Industrial Blvd, Houma, 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 |
---|---|---|---|
1659695674 | NPI | - | NPPES |
2109022 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ZP0101X | Pathology - Anatomic Pathology | MD.205335 (Louisiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Leonard J Chabert Medical Center | Houma, LA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
South Louisiana Medical Associates | 8527968650 | 104 |
Entity Name | South Louisiana Medical Associates |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942301379 PECOS PAC ID: 8527968650 Enrollment ID: O20040113000589 |
Mailing Address | Practice Location Address |
---|---|
Mr Ronnie Self Ii, 1990 Industrial Blvd, Houma, LA 70363-7055 Ph: (985) 868-9300 | Mr Ronnie Self Ii, 1990 Industrial Blvd, Houma, LA 70363-7055 Ph: (985) 868-9300 |
Gerard Anthony Bertolino, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 1990 Industrial Blvd, Houma, LA 70363 Phone: 985-868-9300 Fax: 985-851-0053 | |
Feaster F Fitzpatrick, Pathology Medicare: Not Enrolled in Medicare Practice Location: 8166 Main Street, Houma, LA 70360 Phone: 985-873-4141 Fax: 985-851-4307 | |
Willard T Dalton Jr., MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 8166 Main Street, Houma, LA 70360 Phone: 985-873-4141 Fax: 985-851-4307 | |
Rebecca Leigh Boyd Whittemore, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 1990 Industrial Blvd, South Louisiana Medical Associates, Houma, LA 70363 Phone: 985-873-1335 Fax: 985-873-1225 | |
Steven D Kraus, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 1978 Industrial Blvd, Pathology Dept., Houma, LA 70363 Phone: 985-868-9300 | |
Dr. Sudha G Pillarisetti, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 1990 Industrial Blvd, Houma, LA 70363 Phone: 985-868-9300 Fax: 985-851-0053 |