| Mmg Nelson Rd Llc | |
|
4345 Nelson Rd Ste 102 Lake Charles LA 70605-4183 | |
| (337) 480-7900 | |
| (337) 602-6358 |
| Full Name | Mmg Nelson Rd Llc |
|---|---|
| Speciality | General Practice |
| Location | 4345 Nelson Rd Ste 102, Lake Charles, Louisiana |
| Authorized Official Name and Position | Dawn Johnson-hatcher (CFO) |
| Authorized Official Contact | 3374942094 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmg Nelson Rd Llc Po Box 123594 Dept 3594 Dallas TX 75312-3594 Ph: (337) 494-2921 | Mmg Nelson Rd Llc 4345 Nelson Rd Ste 102 Lake Charles LA 70605-4183 Ph: (337) 480-7900 |
| NPI Number | 1295103844 |
|---|---|
| Provider Enumeration Date | 09/11/2015 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/04/2023 |
| Medicare PECOS PAC ID | 9032407663 |
|---|---|
| Medicare Enrollment ID | O20161013001076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295103844 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | William C Nabours |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659371193 PECOS PAC ID: 9931002508 Enrollment ID: I20040130000300 |
| Provider Name | Kendra B Meche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326295239 PECOS PAC ID: 5395813083 Enrollment ID: I20081010000076 |
| Provider Name | Joshua A Whatley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386961787 PECOS PAC ID: 6406027051 Enrollment ID: I20110912000697 |
| Provider Name | Robert Joseph Vangossen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437546595 PECOS PAC ID: 3476857947 Enrollment ID: I20181106000989 |
| Provider Name | Jennifer Powers Trombatore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346893732 PECOS PAC ID: 3173955366 Enrollment ID: I20191108000518 |
| Provider Name | Christian Leblanc |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689115966 PECOS PAC ID: 2264702026 Enrollment ID: I20200616002717 |
| Provider Name | Joshua Benjamin Bacon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396274551 PECOS PAC ID: 6709155765 Enrollment ID: I20200713002906 |
Gulf Coast Social Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 Pujo St Ste A, Lake Charles, LA 70601 Phone: 337-436-6622 Fax: 337-436-4403 | |
New Beginnings Community Outreach Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Lakeshore Dr Ste 1640e, Lake Charles, LA 70629 Phone: 337-794-5351 Fax: 337-433-4894 | |
Family And Youth Counseling Agency, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 220 Louie St, Lake Charles, LA 70601 Phone: 337-436-9533 Fax: 337-439-9941 | |
Saint Nicholas Center For Early Intervention Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 314 Broad St, Suite B, Lake Charles, LA 70601 Phone: 337-491-0800 Fax: 337-491-0508 | |
Volunteers Of America Greater Baton Rouge Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2119 Oak Park Blvd, Suite 421, Lake Charles, LA 70601 Phone: 225-387-0061 | |
Bloom Behavioral Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 504 E College St, Lake Charles, LA 70605 Phone: 337-240-6038 | |
Jody Davidson Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 315 Alamo St, Lake Charles, LA 70601 Phone: 337-794-1141 |