| |
425 S Vine St Bastrop LA 71220-4513 | |
(318) 283-3960 | |
(318) 239-8960 |
Full Name | |
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Speciality | Clinic/Center |
Location | 425 S Vine St, Bastrop, Louisiana |
Authorized Official Name and Position | Elmore Patterson (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3182833602 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 293 Bastrop LA 71221-0293 Ph: (318) 283-3620 | 425 S Vine St Bastrop LA 71220-4513 Ph: (318) 283-3960 |
NPI Number | 1891013496 |
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Provider Enumeration Date | 05/07/2010 |
Last Update Date | 11/15/2024 |
Medicare PECOS PAC ID | 6507990165 |
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Medicare Enrollment ID | O20100818000213 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891013496 | NPI | - | NPPES |
2114646 | Medicaid | LA |
Provider Name | Jeffrey Counts |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1710962444 PECOS PAC ID: 0446278121 Enrollment ID: I20051110000981 |
Provider Name | Tonya H Hunter |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1770586067 PECOS PAC ID: 4082677695 Enrollment ID: I20060918000057 |
Provider Name | Deborah C Green |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710023007 PECOS PAC ID: 1456435601 Enrollment ID: I20080226000662 |
Provider Name | Timothy Spires |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1346257870 PECOS PAC ID: 2961555826 Enrollment ID: I20090725000042 |
Provider Name | Curtis Sanders |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1144232430 PECOS PAC ID: 7517002140 Enrollment ID: I20100305000848 |
Provider Name | James M Smith |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1225065709 PECOS PAC ID: 3870599772 Enrollment ID: I20100618000012 |
Provider Name | Bal R Bhandari |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1063473494 PECOS PAC ID: 7618010661 Enrollment ID: I20100622000314 |
Provider Name | White Solomon Graves |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1194700021 PECOS PAC ID: 2769445378 Enrollment ID: I20100712000507 |
Provider Name | David Moan Trettin |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1902881758 PECOS PAC ID: 1456338201 Enrollment ID: I20101020000093 |
Provider Name | Lynn Milliman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790824498 PECOS PAC ID: 0042404931 Enrollment ID: I20101104000950 |
Provider Name | Danier D Anderson |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1639347073 PECOS PAC ID: 0446448237 Enrollment ID: I20101221000288 |
Provider Name | Renita Smalley Bryant |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467748459 PECOS PAC ID: 0749450294 Enrollment ID: I20110819000299 |
Provider Name | Martin Joseph Degravelle |
---|---|
Provider Type | Practitioner - Hand Surgery |
Provider Identifiers | NPI Number: 1457520801 PECOS PAC ID: 1759547474 Enrollment ID: I20120725000382 |
Provider Name | Kristopher Charles Sirmon |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1295976280 PECOS PAC ID: 7517187131 Enrollment ID: I20141002002204 |
Provider Name | Lisa A Post |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1508848623 PECOS PAC ID: 6002823929 Enrollment ID: I20150408000527 |
Provider Name | Maribeth W Gambill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144334863 PECOS PAC ID: 9234144791 Enrollment ID: I20160404000372 |
Provider Name | Pamela Suzette Eisler |
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Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1699138867 PECOS PAC ID: 8325347313 Enrollment ID: I20160426000296 |
Provider Name | Joy Huggins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386007672 PECOS PAC ID: 8820384738 Enrollment ID: I20160901000121 |
Provider Name | Elliott Branscome Nipper |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1902811300 PECOS PAC ID: 1355345158 Enrollment ID: I20171011003372 |
Provider Name | Tiffany Lasheu Tolliver-battle |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013424670 PECOS PAC ID: 4688935281 Enrollment ID: I20180222001119 |
Provider Name | Stanley Douglas Crawford |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1497171888 PECOS PAC ID: 1951635077 Enrollment ID: I20200520001656 |
Provider Name | Cameron Michael Best |
---|---|
Provider Type | Practitioner - Hand Surgery |
Provider Identifiers | NPI Number: 1912160748 PECOS PAC ID: 4587880281 Enrollment ID: I20210520001838 |
Provider Name | William Patrick Ensminger |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1740644665 PECOS PAC ID: 8123313053 Enrollment ID: I20220901000353 |
Provider Name | Laquinten Cordelyona Peterson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154015329 PECOS PAC ID: 4385007863 Enrollment ID: I20230831000313 |
Provider Name | Jessica Pack |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982319067 PECOS PAC ID: 7416313697 Enrollment ID: I20240830000590 |
Camilla Carter, Md & Carter Cox Jr., Md Apc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 South Vine Street, Bastrop, LA 71220 Phone: 318-281-3521 Fax: 318-281-3537 | |
Robert E Lyon Internal Medicine, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 Gunby Ave, Bastrop, LA 71220 Phone: 318-281-3432 Fax: 318-281-8850 | |