Jimmy R Coughran A Medical Corporation | |
101 Fair Avenue Winnsboro LA 71295-2116 | |
(318) 435-8020 | |
Not Available |
Full Name | Jimmy R Coughran A Medical Corporation |
---|---|
Speciality | Family Medicine |
Location | 101 Fair Avenue, Winnsboro, Louisiana |
Authorized Official Name and Position | Jimmy R Coughran (OWNER) |
Authorized Official Contact | 3184358020 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Jimmy R Coughran A Medical Corporation Po Box 730 Winnsboro LA 71295-0730 Ph: (318) 435-8020 | Jimmy R Coughran A Medical Corporation 101 Fair Avenue Winnsboro LA 71295-2116 Ph: (318) 435-8020 |
NPI Number | 1982748224 |
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Provider Enumeration Date | 02/19/2007 |
Last Update Date | 12/13/2012 |
Medicare PECOS PAC ID | 2769430347 |
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Medicare Enrollment ID | O20050111000076 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982748224 | NPI | - | NPPES |
1449130 | Medicaid | LA | |
L92023 | Other | LA | VANTAGE PROVIDER NO |
5287021 | Other | LA | AETNA PROVIDER NUMBER |
433374280A | Other | LA | BCBS OF LA PROVIDER NO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 021579 (Louisiana) | Primary |
Provider Name | Erin Hayden Griffin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255414181 PECOS PAC ID: 8729044599 Enrollment ID: I20041203000128 |
Provider Name | Jimmy R Coughran |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568438323 PECOS PAC ID: 5294783874 Enrollment ID: I20050112000000 |
Provider Name | Cynthia M Gray |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104140987 PECOS PAC ID: 2567359698 Enrollment ID: I20100301000817 |
Provider Name | Billie Jo Bailey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952601809 PECOS PAC ID: 4789871336 Enrollment ID: I20101208000297 |
Provider Name | Jessica M Pearson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184934002 PECOS PAC ID: 3577745363 Enrollment ID: I20110316000110 |
Provider Name | Shelby S Vascocu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730619529 PECOS PAC ID: 0446522114 Enrollment ID: I20170816001984 |
Provider Name | Amy Renee Mcnaughton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174052724 PECOS PAC ID: 7810256724 Enrollment ID: I20180123002387 |
Provider Name | John Bradley Clifton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427515915 PECOS PAC ID: 5991044810 Enrollment ID: I20190311001725 |
Provider Name | Ashley Cheek |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518525419 PECOS PAC ID: 0547594384 Enrollment ID: I20190627000933 |
Provider Name | John Tyler Ulmer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023640331 PECOS PAC ID: 9537599402 Enrollment ID: I20200416000160 |
Provider Name | Bridget M Hosea |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013527308 PECOS PAC ID: 2567870835 Enrollment ID: I20210427000223 |
Provider Name | Kaycie Posey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932831500 PECOS PAC ID: 3072994979 Enrollment ID: I20220725000995 |
Provider Name | Megan Petty Gimber |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114648268 PECOS PAC ID: 7618344763 Enrollment ID: I20221103000230 |
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