Desoto Hospital Association | |
207 Jefferson St Mansfield LA 71052-2603 | |
(318) 872-4610 | |
(318) 872-1502 |
Full Name | Desoto Hospital Association |
---|---|
Speciality | General Acute Care Hospital |
Location | 207 Jefferson St, Mansfield, Louisiana |
Authorized Official Name and Position | Todd Eppler (CEO) |
Authorized Official Contact | 3188724610 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Desoto Hospital Association 207 Jefferson St Mansfield LA 71052-2603 Ph: (318) 872-4610 | Desoto Hospital Association 207 Jefferson St Mansfield LA 71052-2603 Ph: (318) 872-4610 |
NPI Number | 1467455154 |
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Provider Enumeration Date | 05/27/2005 |
Last Update Date | 07/09/2021 |
Certification Date | 07/09/2021 |
Medicare PECOS PAC ID | 2163321829 |
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Medicare Enrollment ID | O20040102000229 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467455154 | NPI | - | NPPES |
1743283 | Medicaid | LA | |
04700 | Other | BLUE CROSS | |
119678402 | Medicaid | TX | |
1750131 | Medicaid | LA | |
90118 | Other | BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
282N00000X | General Acute Care Hospital | 229 (Louisiana) | Primary |
Provider Name | Richa Dhawan |
---|---|
Provider Type | Practitioner - Rheumatology |
Provider Identifiers | NPI Number: 1194921718 PECOS PAC ID: 9234043886 Enrollment ID: I20031118000146 |
Provider Name | Benjamin L Leggio |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1851370332 PECOS PAC ID: 6507769916 Enrollment ID: I20040131000125 |
Provider Name | James Harper |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003808569 PECOS PAC ID: 0446141766 Enrollment ID: I20040324000479 |
Provider Name | Lori Eubanks |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982717716 PECOS PAC ID: 9931192713 Enrollment ID: I20040407000142 |
Provider Name | Chi Tai P Lau |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1750340592 PECOS PAC ID: 9931167509 Enrollment ID: I20050311000626 |
Provider Name | Vesela T Tzoneva |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1356436794 PECOS PAC ID: 4385641372 Enrollment ID: I20061106000192 |
Provider Name | David M Abdehou |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1568471993 PECOS PAC ID: 7810094265 Enrollment ID: I20070518000213 |
Provider Name | Douglas Matthew Casey |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1942498613 PECOS PAC ID: 3870674914 Enrollment ID: I20080115000623 |
Provider Name | Brenton W Mcdonald |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1528094455 PECOS PAC ID: 1254417132 Enrollment ID: I20080319000043 |
Provider Name | Melissa Richardson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790750362 PECOS PAC ID: 3274603329 Enrollment ID: I20080602000798 |
Provider Name | William M Wilder |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1730120312 PECOS PAC ID: 6406872134 Enrollment ID: I20090520000335 |
Provider Name | Marcus V Stelly |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1225206212 PECOS PAC ID: 1759412554 Enrollment ID: I20100623000074 |
Provider Name | Chad T Porter |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1669652665 PECOS PAC ID: 0547391229 Enrollment ID: I20100624000002 |
Provider Name | Gary V Burton |
---|---|
Provider Type | Practitioner - Hematology/oncology |
Provider Identifiers | NPI Number: 1316968761 PECOS PAC ID: 8426172107 Enrollment ID: I20100901000936 |
Provider Name | Nima Alinejad |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1043310808 PECOS PAC ID: 7214074418 Enrollment ID: I20120206000670 |
Provider Name | Ralph L Abraham |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1639346174 PECOS PAC ID: 2365686391 Enrollment ID: I20130913000109 |
Provider Name | Stacey Leanne Dillard |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1710250204 PECOS PAC ID: 2365690864 Enrollment ID: I20131203001563 |
Provider Name | Morgan Cheatham Haile |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1760655500 PECOS PAC ID: 6901060292 Enrollment ID: I20140127001269 |
Provider Name | Justin Pham |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1821040866 PECOS PAC ID: 0042104754 Enrollment ID: I20141022000483 |
Provider Name | Matthew K Dang |
---|---|
Provider Type | Practitioner - Interventional Radiology |
Provider Identifiers | NPI Number: 1588848857 PECOS PAC ID: 7517131147 Enrollment ID: I20150130000807 |
Provider Name | Jessica D Caraway |
---|---|
Provider Type | Practitioner - Interventional Radiology |
Provider Identifiers | NPI Number: 1710120274 PECOS PAC ID: 6103130463 Enrollment ID: I20150730011487 |
Provider Name | Brian Sterling Dupree |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1275780447 PECOS PAC ID: 1759684442 Enrollment ID: I20160130000116 |
Provider Name | Anand M Desai |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1821433103 PECOS PAC ID: 7911205174 Enrollment ID: I20160620000756 |
Provider Name | Caleb Blair Harkins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053762146 PECOS PAC ID: 5294028205 Enrollment ID: I20160728002067 |
Provider Name | Kimberly A Rials |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861841884 PECOS PAC ID: 5395033088 Enrollment ID: I20161012002142 |
Provider Name | Angela Christine Taylor |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942650429 PECOS PAC ID: 7517250020 Enrollment ID: I20170425000658 |
Provider Name | Larry D Allen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942660287 PECOS PAC ID: 4082987334 Enrollment ID: I20170907002321 |
Provider Name | Claire A Bradley |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1396905477 PECOS PAC ID: 0840564738 Enrollment ID: I20170915000899 |
Provider Name | Brandon Javier Salgado |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1710243340 PECOS PAC ID: 8820301898 Enrollment ID: I20180907001543 |
Provider Name | Naishia L Pipkins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881943637 PECOS PAC ID: 6103129101 Enrollment ID: I20180924000335 |
Provider Name | Jason Patrick Calligas |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1700102449 PECOS PAC ID: 2769767573 Enrollment ID: I20190826003155 |
Provider Name | Vikram Mysore Hatti |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1447202460 PECOS PAC ID: 3476554783 Enrollment ID: I20191007003390 |
Provider Name | Poornima Ramadas |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225442254 PECOS PAC ID: 8022355403 Enrollment ID: I20200624001816 |
Provider Name | Jacqueline Loche |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205434768 PECOS PAC ID: 2769892090 Enrollment ID: I20201028000072 |
Provider Name | Stephen Johnston |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1730525841 PECOS PAC ID: 0042574048 Enrollment ID: I20220307000090 |
Provider Name | Sameh Sakla |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1518250307 PECOS PAC ID: 5294080230 Enrollment ID: I20220824003695 |
Provider Name | Caleb Ruben Rivera |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1164410916 PECOS PAC ID: 5496791857 Enrollment ID: I20240308002322 |
Provider Name | Mikki Marie Olsson |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1144994146 PECOS PAC ID: 2062850407 Enrollment ID: I20240404002607 |
Provider Name | Ryan Keith Tompkins |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1619064623 PECOS PAC ID: 1052493152 Enrollment ID: I20240416002479 |
Provider Name | Ronald Regan Winters |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1437593779 PECOS PAC ID: 8123382397 Enrollment ID: I20240503001227 |
Provider Name | Matthew Howard Smith |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1275869729 PECOS PAC ID: 6103148127 Enrollment ID: I20240513000864 |
Mansfield Behavioral Health Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Louisiana Avenue, Mansfield, LA 71052 Phone: 318-872-5576 Fax: 318-872-9780 | |
Mansfield Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Louisiana St, Mansfield, LA 71052 Phone: 318-872-5576 | |
Outreach Family Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 Washington Ave, Mansfield, LA 71052 Phone: 318-872-0262 | |
Desoto Regional Health System Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 Jefferson St, Mansfield, LA 71052 Phone: 318-872-4610 Fax: 318-872-1502 | |
Cognitive Institute Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 Polk St, Mansfield, LA 71052 Phone: 318-871-5566 Fax: 318-871-1076 | |
Volunteers Of America Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1915 Mcarthur Dr, Mansfield, LA 71052 Phone: 318-872-1772 |