| Wk Family Medicine Ruston | |
|
2916 N Trenton St Ruston LA 71270-2444 | |
| (318) 254-2892 | |
| (318) 635-9857 |
| Full Name | Wk Family Medicine Ruston |
|---|---|
| Speciality | Family Medicine |
| Location | 2916 N Trenton St, Ruston, Louisiana |
| Authorized Official Name and Position | Mary J Ward (SR. VP FINANCE) |
| Authorized Official Contact | 3187164939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wk Family Medicine Ruston 2916 N Trenton St Ruston LA 71270-2444 Ph: (318) 254-2892 | Wk Family Medicine Ruston 2916 N Trenton St Ruston LA 71270-2444 Ph: (318) 254-2892 |
| NPI Number | 1295435337 |
|---|---|
| Provider Enumeration Date | 03/07/2023 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 0840656674 |
|---|---|
| Medicare Enrollment ID | O20230519001564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295435337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Benson Grigsby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487687513 PECOS PAC ID: 4880612241 Enrollment ID: I20061102000465 |
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