| Mrs Lori A Stackow, PAC | |
|
1541 Kings Hwy, Shreveport, LA 71103-4228 | |
| (318) 626-0000 | |
| (318) 629-4833 |
| Full Name | Mrs Lori A Stackow |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 33 Years |
| Location | 1541 Kings Hwy, Shreveport, Louisiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467449835 | NPI | - | NPPES |
| 49008 | Other | WA | DEPT OF LABOR AND INDUSTR |
| 8434896 | Medicaid | WA | |
| 004385800 | Medicaid | ID | |
| 153449704 | Medicaid | TX | |
| PAJB6 | Other | ID | BLUE CROSS OF ID |
| 000010017182 | Other | ID | REGENCE BS OF ID |
| 601417200 | Other | DEEIOC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA10687 (Texas) | Secondary |
| 363A00000X | Physician Assistant | 332160 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ochsner Lsu Health Shreveport | Shreveport, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lsu Health Sciences Center Shreveport Faculty Group Practice | 4082902721 | 534 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Lori A Stackow, PAC 1512 W Kirby Pl, Shreveport, LA 71103-3822 Ph: (318) 626-0177 | Mrs Lori A Stackow, PAC 1541 Kings Hwy, Shreveport, LA 71103-4228 Ph: (318) 626-0000 |
Tate James Perque, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1453 E Bert Kouns Industrial Loop Ste 318, Shreveport, LA 71105 Phone: 318-681-1968 Fax: 318-681-1969 | |
Jennifer B Cypher, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Mrs. Kristi Harrison Gaspard, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 8383 Millicent Way, Shreveport, LA 71115 Phone: 318-797-6661 Fax: 318-795-8512 | |
Susan Lenora Steen, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1501 Kings Hwy, Department Of Neurosurgery, Shreveport, LA 71103 Phone: 318-675-6901 Fax: 318-675-4819 | |
Jeanette Catherine Pang, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 7925 Youree Dr Ste 200, Shreveport, LA 71105 Phone: 318-212-3610 Fax: 318-212-3709 | |
Dakota Shayne Barlow, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1666 E Bert Kouns Industrial Loop Ste 105, Shreveport, LA 71105 Phone: 318-212-3520 | |
Carson Elizabeth Shetley, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 |