| Wk Swan Lake Diabetes & Endocrinology | |
|
5341 Airline Drive Suite 100 Bossier City LA 71111 | |
| (318) 935-1810 | |
| (318) 935-1867 |
| Full Name | Wk Swan Lake Diabetes & Endocrinology |
|---|---|
| Speciality | Internal Medicine |
| Location | 5341 Airline Drive, Bossier City, Louisiana |
| Authorized Official Name and Position | Mary Jane Ward (SR. VP FINANCE) |
| Authorized Official Contact | 3187164937 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wk Swan Lake Diabetes & Endocrinology 5341 Airline Drive Suite 100 Bossier City LA 71111 Ph: (318) 935-1810 | Wk Swan Lake Diabetes & Endocrinology 5341 Airline Drive Suite 100 Bossier City LA 71111 Ph: (318) 935-1810 |
| NPI Number | 1326730573 |
|---|---|
| Provider Enumeration Date | 05/25/2023 |
| Last Update Date | 05/25/2023 |
| Medicare PECOS PAC ID | 5799139697 |
|---|---|
| Medicare Enrollment ID | O20230926004062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326730573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Derek T Rainwater |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548767437 PECOS PAC ID: 0244584662 Enrollment ID: I20201210000224 |
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Willow Chute Medical, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4910 Airline Dr, Bossier City, LA 71111 Phone: 318-349-3921 | |
Abaka Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4438 Viking Dr, Bossier City, LA 71111 Phone: 318-918-0015 Fax: 318-963-0015 | |
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Injurymd Of Bossier, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5015 Shed Rd Ste 500, Bossier City, LA 71111 Phone: 318-741-5858 Fax: 318-741-4496 |