Michael Brooks Family Clinic | |
612 S Farmerville Street Ruston LA 71270 | |
(318) 436-2600 | |
Not Available |
Full Name | Michael Brooks Family Clinic |
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Speciality | Family Medicine |
Location | 612 S Farmerville Street, Ruston, Louisiana |
Authorized Official Name and Position | Chris L Bowman (OFFICER) |
Authorized Official Contact | 3162596200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Michael Brooks Family Clinic Po Box 445 Ruston LA 71273-0445 Ph: (318) 436-2600 | Michael Brooks Family Clinic 612 S Farmerville Street Ruston LA 71270 Ph: (318) 436-2600 |
NPI Number | 1245708718 |
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Provider Enumeration Date | 11/02/2018 |
Last Update Date | 07/10/2019 |
Medicare PECOS PAC ID | 2860734415 |
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Medicare Enrollment ID | O20190430002363 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245708718 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Enaka Yembe |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1003874314 PECOS PAC ID: 5799723292 Enrollment ID: I20050425000110 |
Provider Name | Patricia D Mcgovern |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134313331 PECOS PAC ID: 8527152297 Enrollment ID: I20070926000282 |
Provider Name | Natalie Saunders Wise |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801227392 PECOS PAC ID: 3274764006 Enrollment ID: I20140320001006 |
Provider Name | Melissa D Futrell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366823809 PECOS PAC ID: 7416260914 Enrollment ID: I20150713001698 |
Provider Name | Krystle Cash-shaw |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285284612 PECOS PAC ID: 9638505068 Enrollment ID: I20200204000720 |
Provider Name | Roberto Rodriquez Monsanto |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417504093 PECOS PAC ID: 7517387822 Enrollment ID: I20201026000659 |
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