Mrs Allison Renee Dupuis Prevost, M D | |
2647 S Saint Elizabeth Blvd Ste 320, Gonzales, LA 70737-5017 | |
(225) 647-8511 | |
(225) 647-5093 |
Full Name | Mrs Allison Renee Dupuis Prevost |
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Gender | Female |
Speciality | Pediatrics |
Location | 2647 S Saint Elizabeth Blvd Ste 320, Gonzales, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1184069346 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 302658 (Louisiana) | Primary |
Entity Name | Our Lady Of Lake Ascension, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306899067 PECOS PAC ID: 3577452259 Enrollment ID: O20040311000822 |
Entity Name | Our Lady Of The Lake Physician Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377 |
Mailing Address | Practice Location Address |
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Mrs Allison Renee Dupuis Prevost, M D 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (225) 526-0018 | Mrs Allison Renee Dupuis Prevost, M D 2647 S Saint Elizabeth Blvd Ste 320, Gonzales, LA 70737-5017 Ph: (225) 647-8511 |
Dr. Brittany Alexis Landry, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2400 S Burnside Ave, Gonzales, LA 70737 Phone: 225-761-5200 Fax: 225-709-6425 | |
Cammie A Hilliard, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1937 S Burnside Ave, Gonzales, LA 70737 Phone: 225-765-5500 Fax: 225-644-9286 | |
Leyamma Mathew, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 721 E Highway 30, Gonzales, LA 70737 Phone: 225-644-7337 Fax: 225-644-5202 | |
Sarah Wilks, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1702 N Burnside Ave Ste C, Gonzales, LA 70737 Phone: 225-765-5500 Fax: 225-644-0341 | |
Dawn Zitman, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1937 S Burnside Ave, Gonzales, LA 70737 Phone: 225-765-5500 Fax: 225-644-9286 | |
Tracy Wallace, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1937 S Burnside Ave, Gonzales, LA 70737 Phone: 225-765-5500 Fax: 225-644-9286 |