| Shreveport Internal Medicine, Llc | |
|
1449 E Bert Kouns Industrial Loop Suite 100 Shreveport LA 71105-5634 | |
| (318) 629-0220 | |
| Not Available |
| Full Name | Shreveport Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1449 E Bert Kouns Industrial Loop, Shreveport, Louisiana |
| Authorized Official Name and Position | Richard E. Haynie (PRESIDENT) |
| Authorized Official Contact | 3186212929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shreveport Internal Medicine, Llc 1449 E Bert Kouns Industrial Loop Suite 100 Shreveport LA 71105-5634 Ph: (318) 629-0220 | Shreveport Internal Medicine, Llc 1449 E Bert Kouns Industrial Loop Suite 100 Shreveport LA 71105-5634 Ph: (318) 629-0220 |
| NPI Number | 1700838513 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5496767865 |
|---|---|
| Medicare Enrollment ID | O20060629000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700838513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Louisiana) | Primary |
| Provider Name | Craig L Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174590848 PECOS PAC ID: 6800806258 Enrollment ID: I20060428000354 |
| Provider Name | Mark A Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750344073 PECOS PAC ID: 5799795142 Enrollment ID: I20060428000368 |
| Provider Name | Eric W Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417910720 PECOS PAC ID: 3971532078 Enrollment ID: I20060428000395 |
| Provider Name | Richard E Haynie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275596587 PECOS PAC ID: 8224048699 Enrollment ID: I20060428000569 |
| Provider Name | Ashley D Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306287784 PECOS PAC ID: 0345484705 Enrollment ID: I20130925000310 |
| Provider Name | Mary S Inman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780237701 PECOS PAC ID: 3072842954 Enrollment ID: I20190903002216 |
Hs Louisiana, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Kings Hwy, Suite 5-303, Shreveport, LA 71103 Phone: 904-834-2679 Fax: 904-395-3249 | |
Wk Digestive Disease Consultants Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2508 Bert Koun Loop, Sutie 304, Shreveport, LA 71118 Phone: 318-671-8880 Fax: 318-671-8879 | |
Andrew Dentino Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2551 Greenwood Rd, Suite 310, Shreveport, LA 71103 Phone: 318-212-8780 Fax: 318-212-8181 | |
Paul S Wilson Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1666 E Bert Kouns Industrial Loop, Suite 230, Shreveport, LA 71105 Phone: 318-212-3970 Fax: 318-212-3975 | |
Maurie Patterson Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8001 Youree Dr, Suite 400, Shreveport, LA 71115 Phone: 318-212-3456 Fax: 318-212-3885 | |
Raymond A. Coghlan Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2551 Greenwood Rd, Suite 150, Shreveport, LA 71103 Phone: 318-631-9996 Fax: 318-631-9345 | |
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