| Wk Pierremont Family Physicians | |
|
8001 Youree Dr Suite 540 Shreveport LA 71115-2302 | |
| (318) 212-3793 | |
| (318) 212-3799 |
| Full Name | Wk Pierremont Family Physicians |
|---|---|
| Speciality | Family Medicine |
| Location | 8001 Youree Dr, Shreveport, Louisiana |
| Authorized Official Name and Position | Greg J. Gavin (NETWORK ADMINISTRATOR) |
| Authorized Official Contact | 3182124232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wk Pierremont Family Physicians 8001 Youree Dr Suite 540 Shreveport LA 71115-2302 Ph: (318) 212-3793 | Wk Pierremont Family Physicians 8001 Youree Dr Suite 540 Shreveport LA 71115-2302 Ph: (318) 212-3793 |
| NPI Number | 1497876189 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 06/08/2012 |
| Medicare PECOS PAC ID | 0143320465 |
|---|---|
| Medicare Enrollment ID | O20070716000076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497876189 | NPI | - | NPPES |
| 1009091 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Susan M Self |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023047149 PECOS PAC ID: 2466416599 Enrollment ID: I20041117000969 |
| Provider Name | Wendy M Moses |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487681730 PECOS PAC ID: 4183689219 Enrollment ID: I20041130000748 |
| Provider Name | April C Palmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104830306 PECOS PAC ID: 0244247872 Enrollment ID: I20060307000593 |
| Provider Name | Russell S Carr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245205335 PECOS PAC ID: 0648370981 Enrollment ID: I20070716000237 |
| Provider Name | Larry Flake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386670917 PECOS PAC ID: 9537260369 Enrollment ID: I20070724000587 |
| Provider Name | Sara Amend Blankenship |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811518780 PECOS PAC ID: 5294144432 Enrollment ID: I20210429001413 |
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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 | |
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