| Dr. K's Family Medicine | |
|
2781 S Columbia St Suite A Bogalusa LA 70427-7962 | |
| (229) 869-0294 | |
| Not Available |
| Full Name | Dr. K's Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 2781 S Columbia St, Bogalusa, Louisiana |
| Authorized Official Name and Position | Keisha Harvey (PRESIDENT) |
| Authorized Official Contact | 2298290294 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. K's Family Medicine 2871 S. Columbia St Ste A Bogalusa LA 70427 Ph: () - | Dr. K's Family Medicine 2781 S Columbia St Suite A Bogalusa LA 70427-7962 Ph: (229) 869-0294 |
| NPI Number | 1265971147 |
|---|---|
| Provider Enumeration Date | 02/13/2017 |
| Last Update Date | 07/12/2023 |
| Medicare PECOS PAC ID | 9335426121 |
|---|---|
| Medicare Enrollment ID | O20170504000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265971147 | NPI | - | NPPES |
| MD206754 | Other | LSBME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Keisha D Harvey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821355637 PECOS PAC ID: 5597980631 Enrollment ID: I20140707000328 |
| Provider Name | Kristin Diondre Lynch Grimes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558603563 PECOS PAC ID: 2668773375 Enrollment ID: I20180221000734 |
| Provider Name | Thomandra Shavaun Sam |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477850667 PECOS PAC ID: 2860864618 Enrollment ID: I20230204000522 |
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