Mr Donald Glyn Gardner Ii, | |
324 Blue Fox Cir, Haughton, LA 71037-7707 | |
(318) 401-6258 | |
Not Available |
Full Name | Mr Donald Glyn Gardner Ii |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 4 Years |
Location | 324 Blue Fox Cir, Haughton, 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 |
---|---|---|---|
1578183208 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 214187 (Louisiana) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Lsu Health Sciences Center Shreveport Faculty Group Practice | 4082902721 | 534 |
Entity Name | Lsu Health Sciences Center Shreveport Faculty Group Practice |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013374222 PECOS PAC ID: 4082902721 Enrollment ID: O20161012000307 |
Entity Name | University Health Shreveport, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619443611 PECOS PAC ID: 7416207196 Enrollment ID: O20181109000875 |
Mailing Address | Practice Location Address |
---|---|
Mr Donald Glyn Gardner Ii, 324 Blue Fox Cir, Haughton, LA 71037-7707 Ph: (318) 401-6258 | Mr Donald Glyn Gardner Ii, 324 Blue Fox Cir, Haughton, LA 71037-7707 Ph: (318) 401-6258 |
Cassanda Howell Maxwell, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1025 Highway 80, Haughton, LA 71037 Phone: 318-949-0539 Fax: 318-949-0759 | |
Shondreika Tenae Davis, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 316 Wood Spgs, Haughton, LA 71037 Phone: 318-730-3888 | |
Andreka Winston, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 170 Health Care Drive, Haughton, LA 71037 Phone: 318-706-0022 |