Clhg-ruston Llc | |
1200 Celebrity Dr Ruston LA 71270-3893 | |
(318) 254-2100 | |
Not Available |
Full Name | Clhg-ruston Llc |
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Speciality | Family Medicine |
Location | 1200 Celebrity Dr, Ruston, Louisiana |
Authorized Official Name and Position | Kathy M Hall (CEO) |
Authorized Official Contact | 3182542450 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Clhg-ruston Llc 1200 Celebrity Dr Ruston LA 71270-3893 Ph: () - | Clhg-ruston Llc 1200 Celebrity Dr Ruston LA 71270-3893 Ph: (318) 254-2100 |
NPI Number | 1154012185 |
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Provider Enumeration Date | 05/19/2023 |
Last Update Date | 05/19/2023 |
Medicare PECOS PAC ID | 7315361425 |
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Medicare Enrollment ID | O20220718002173 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154012185 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Bobby T Ensminger |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508813742 PECOS PAC ID: 3870490980 Enrollment ID: I20031217000314 |
Provider Name | Aaron Marquardt |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538349733 PECOS PAC ID: 7315129038 Enrollment ID: I20110316000598 |
Provider Name | Savannah T Ray |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285996306 PECOS PAC ID: 1557527793 Enrollment ID: I20120716000570 |
Provider Name | Robert Todd Rickman |
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Provider Type | Practitioner - Critical Care (intensivists) |
Provider Identifiers | NPI Number: 1417168782 PECOS PAC ID: 0042476418 Enrollment ID: I20120730000646 |
Provider Name | Kamal A Masri |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1134418437 PECOS PAC ID: 8022232305 Enrollment ID: I20150129001319 |
Provider Name | Kevin M Langlois |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1184997264 PECOS PAC ID: 6204145261 Enrollment ID: I20151014002501 |
Provider Name | Stavan Y Patel |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1558688309 PECOS PAC ID: 6507161817 Enrollment ID: I20160721001012 |
Provider Name | Jennifer Calvert |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598280752 PECOS PAC ID: 1052684537 Enrollment ID: I20170905002102 |
Provider Name | Ravali Tarigopula |
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Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1285802892 PECOS PAC ID: 0547427346 Enrollment ID: I20180827000633 |
Provider Name | Kevin J Bunn |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1205061504 PECOS PAC ID: 9638480304 Enrollment ID: I20190115003003 |
Provider Name | Erin Michelle Waller |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578036349 PECOS PAC ID: 2567700073 Enrollment ID: I20190207002213 |
Provider Name | Mark David Burns |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558034033 PECOS PAC ID: 1254715725 Enrollment ID: I20220901000407 |
Provider Name | Nancy E Bass |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1811922016 PECOS PAC ID: 1951359975 Enrollment ID: I20230524000472 |
Provider Name | Taylor Blake Boggs |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437937125 PECOS PAC ID: 5991152670 Enrollment ID: I20231117001470 |
Provider Name | Kevin Daniel White |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1548656630 PECOS PAC ID: 8729331970 Enrollment ID: I20240531000594 |
Provider Name | Cameron Lee Mcmahen |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1265010185 PECOS PAC ID: 8123460995 Enrollment ID: I20240613000309 |
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