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CCN Network Provider Listing - Proposal Submission Spreadsheet (G.1)Practitioner Name Business Location Address

LOI Contract STP*

Geocoding

Provider/Practice Name Last Name First Name Title 1st Line of Address City State Latitude LongitudeNATIONAL IMAGING ASSOCIATES 6950 Columbia Gateway Dr Columbia MD 21046 20 30 1 none 1 2 2 39181050 76799574WILMINGTON MEDICAL SUPPLY INC 2309 S. 17th St Wilmington NC 28401 40 54 1 none 1 2 2 34202085 77922746CCS MEDICAL 2105 Newpoint Place Ste 600 Lawrenceville GA 30043 40 54 1 none 1 2 1 33971273 84090186Skin Pathology Associates Bussian Anne H MD 3550 Independence Dr Birmingham AL 35209 20 22 1 None 1 2 2 33469884 86779226Skin Pathology Associates Elder James E MD 3550 Independence Dr Birmingham AL 35209 20 22 1 None 1 2 2 33469884 86779226Skin Pathology Associates Jacobs Michael K MD 3550 Independence Dr Birmingham AL 35209 20 22 1 None 1 2 2 33469884 86779226Skin Pathology Associates Mason Stephen MD 3550 Independence Dr Birmingham AL 35209 20 22 1 None 1 2 2 33469884 86779226Skin Pathology Associates Parrish Charles A MD 3550 Independence Dr Birmingham AL 35209 20 22 1 None 1 2 2 33469884 86779226DIALYSIS CLINIC INC 2917 Foster Creighton Dr Nashville TN 37204 20 30 1 none 1 2 2 36109045 86753926UNITED MEDICAL 810 E. Sunflower Rd. Suite 160 Cleveland MS 38732 40 54 1 none 1 1 2BIENVILLE MEDICAL CENTER Grayson Patrick MD 2517 Lees Path Sevierville TN 37876 20 08 1 None 1 2 2 35854693 83492482

Adderson Elisabeth E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2I 1 none 1 2 2 35153200 90038800

Allison Lenee M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Allred John W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Anderson James F. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Anderson Keith G. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 06 1 none 1 2 2 35153200 90038800

Armstrong Gregory T. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Ault Bettina H. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2K 1 none 1 2 2 35153200 90038800

Aygun Banu 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Bahrami Armita 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 22 1 none 1 2 2 35153200 90038800

Bailey Nancy M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Baker Justin N. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Barnes Nicole S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Barnwell Elizabeth B. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Basco Eduardo V. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 06 1 none 1 2 2 35153200 90038800

Beattie Lisa L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Beckham Penny 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Benedetti Philip 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Betterman Mary Jane 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

CCN Name: Louisiana Healthcare Connections

Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

ST JUDE CHILDREN'S RESEARCH HOSPITAL, INC. dba SJCRH PHYSICIAN


















Practitioner Name Business Location Address

LOI Contract STP*

Geocoding

Provider/Practice Name Last Name First Name Title 1st Line of Address City State Latitude Longitude


Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Bhojwani Deepa 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Birdsell (formerly Prin Katherine E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Black Dennis D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Bloch-Menschik Melissa A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Boston Umar S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 02 1 none 1 2 2 35153200 90038800

Boyd (formerly Jones) Sandra C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Brandon (formerly Hic Leigh M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Broniscer Alberto 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Brown Wendy Thomas 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Brown Amanda M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Emily 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Buckingham Cari L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Bulczak Dariusz P. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Burghen Elizabeth A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Burkholz Kimberly J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Burnette Ken C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Caldemeyer Karen S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Callan Eric W 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Campana Dario 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 22 1 none 1 2 2 35153200 90038800

Campbell Andrew Bruce 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Campbell Patrick K. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Caniza Miguela A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Carbone Laura D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 41 1 >=18 1 2 2 35153200 90038800

Carolino Carmen M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Cash Darlene K. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800












Browne (formerly Kyzer)
















LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Chandler Michelle R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Chapman Lindsay M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Chaum Edward 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Chesney Russell W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2K 1 none 1 2 2 35153200 90038800

Chin Thomas K. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 1D 1 none 1 2 2 35153200 90038800

Cleveland Kerry O. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2I 1 none 1 2 2 35153200 90038800

Cleveland Kevin B. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 20 1 none 1 2 2 35153200 90038800

Cole Robert Jeff 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 20 1 none 1 2 2 35153200 90038800

Coleman Jamie L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Conley Mary Ellen 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 03 1 none 1 2 2 35153200 90038800

Corder Gordon W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Cotton Alyssa N. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Crom Mary D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Dalal Ajay 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 06 1 none 1 2 2 35153200 90038800

Dallas Mari H. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Danley Beverly 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 06 1 none 1 2 2 35153200 90038800

Davidoff Andrew M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 02 1 none 1 2 2 35153200 90038800

Davidson John M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Delos Santos Noel M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2K 1 none 1 2 2 35153200 90038800

DiScenza Sally S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Douglas-McKinley Carla 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Downing James R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 22 1 none 1 2 2 35153200 90038800

Duffy Lauren C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Ellison David W 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 22 1 none 1 2 2 35153200 90038800

Eshun John K. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 10 1 none 1 2 2 35153200 90038800



























LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Fay Thomas A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Ferry Robert J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2E 1 none 1 2 2 35153200 90038800

Fleckenstein Jacquelyn 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 41 1 >=18 1 2 2 35153200 90038800

Fleming James C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Flettrich Deborah D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Flynn Patricia M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Folse Timothy E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 08 1 None 1 2 2 35153200 90038800

Frantz Melinda M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Fritts Sherry B. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Furman Wayne L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Gaillard Pamela A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Gajjar Amar J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Gaur Aditya H. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2I 1 none 1 2 2 35153200 90038800

Geiger Terrence L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 22 1 none 1 2 2 35153200 90038800

Gelfand Michael S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2I 1 none 1 2 2 35153200 90038800

Gold Robert E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Goradia Dhawal A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Green Daniel M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Groben Valerie 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Gruber Tanja A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Hackman Bela B. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 06 1 none 1 2 2 35153200 90038800

Haik Barrett G. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Hakim Hana M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2I 1 none 1 2 2 35153200 90038800

Hale Karen C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Hall Christopher J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 04 1 none 1 2 2 35153200 90038800



























LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Hankins Jane S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Harreld Julie H. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Harrison Ashley 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Hart, Jr. James C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Hartford Christine M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Hastings Margaret Colleen 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2K 1 none 1 2 2 35153200 90038800

Hayden Randall T. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 22 1 none 1 2 2 35153200 90038800

Heck Robert K. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 20 1 none 1 2 2 35153200 90038800

Helton Kathleen J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Hickerson William 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 24 1 none 1 2 2 35153200 90038800

Hodge Sarah E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Hoehn Mary Ellen 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Howard Scott C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Howard Vanessa C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Howlett Nanna M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Hudson Melissa M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Hurt Christopher J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Igarashi Masanori 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Inaba Hiroto 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Ismail Mohammad K. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 10 1 none 1 2 2 35153200 90038800

Jacobsen Jeffrey R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 22 1 none 1 2 2 35153200 90038800

Jeha Sima 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Jenkins, III Jesse J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 22 1 none 1 2 2 35153200 90038800

Jones David F. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Joshi Salil S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800



























LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Joshi Vijaya M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 1D 1 none 1 2 2 35153200 90038800

Kane Javier R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Kaplan Stuart J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Kastan Michael B. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Kaste Sue C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 19 30 1 none 1 2 2 35153200 90038800

Kaufman Robert A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Kennedy Wren T. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Kerr Natalie C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Kimble (formerly ConeAmy E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Knapp Katherine M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2I 1 none 1 2 2 35153200 90038800

Kovach Sandra S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Kozlowski Violetta 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Krasin Matthew J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2J 1 none 1 2 2 35153200 90038800

Kun Larry E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2J 1 none 1 2 2 35153200 90038800

Kundu Mondira 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 22 1 none 1 2 2 35153200 90038800

Lachica Roberto D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 24 1 none 1 2 2 35153200 90038800

Lambert Kimberly B. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Lamptey Aubrey A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Laver Joseph H. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Lawton Andrew W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Lazar Linda F. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 10 1 none 1 2 2 35153200 90038800

Lederman Henrique M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 1 35153200 90038800

Ledet Davonna "Davi" S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Ledoux Matthew R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Leung Wing-Hang 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800



























LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Lewis Jocelyn A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Lowry Patricia A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Luce Edward A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 24 1 none 1 2 2 35153200 90038800

MacDonald Charles B. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 04 1 none 1 2 2 35153200 90038800

Malina Debra P. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Mandrell Belinda N. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Max Anita M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

May Martha V. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

McCarville Mary E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

McCullers Jonathan A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2I 1 none 1 2 2 35153200 90038800

McDade Jenny 262 Danny thomas Place Mailstop 515 Memphis TN 38105 19 37 1 <=18 1 2 2 35153200 90038800

McGregor Amy L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

McGregor Lisa M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

McLevy Jennifer D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 04 1 none 1 2 2 35153200 90038800

McVicar Kathryn A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 13 1 none 1 2 2 35153200 90038800

Merchant Thomas E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 19 2J 1 none 1 2 2 35153200 90038800

Metzger Monika 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Miller Stephen 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Morgan Robin L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 13 1 none 1 2 2 35153200 90038800

Murphy Sandra W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Myers Linda K. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2M 1 none 1 2 2 35153200 90038800

Nair Satheesh 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 41 1 >=18 1 2 2 35153200 90038800

Navid Fariba 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Neel Michael D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 20 1 none 1 2 2 35153200 90038800

Newman Kevin P. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 1D 1 none 1 2 2 35153200 90038800



























LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Nikbakht Stephanie H. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

O'Donnell Thomas J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Ost Shelley R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 41 1 >=18 1 2 2 35153200 90038800

Pai Panandiker Atmaram S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2J 1 none 1 2 2 35153200 90038800

Pappo Alberto S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Partal Andrea E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Patay Zoltan 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Patel Nehali D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2I 1 none 1 2 2 35153200 90038800

Patterson Anthony L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 34 1 none 1 2 2 35153200 90038800

Patterson Jared J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 20 1 none 1 2 2 35153200 90038800

Patricia 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Perkins Freedom F. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 13 1 none 1 2 2 35153200 90038800

Persons Derek A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Phillips (Nancy) Owen P. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 16 1 >=16 1 2 2 35153200 90038800

Pillai Asha B. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Pinlac Rene W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Pivnick Eniko K. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Pritchard Michele 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Proctor Kimberly E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Pui Ching-Hon 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Qaddoumi Ibrahim A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Quiroz Antonio C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 06 1 none 1 2 2 35153200 90038800

Ragon James R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Ragon Kelly R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Ragon William S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800












Pease (formerly Schmidt)
















LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Rao Bhaskar N. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 02 1 none 1 2 2 35153200 90038800

Ratliff Ramona B. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Redd Debbie S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Reiss Ulrike M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Rencher Jacquelyn R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Ribeiro Raul C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Rickman Christopher E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Rieman Martha D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Roberts Donna R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Robinson Diane M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Rossi Michel G. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 05 1 none 1 2 2 35153200 90038800

Rubnitz Jeffrey E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Sabin Noah D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Salazar Jorge A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Samant Sandeep 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 04 1 none 1 2 2 35153200 90038800

Sandlund John T. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Sandoval John A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 02 1 none 1 2 2 35153200 90038800

Sandstrom Tony O. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Santana Victor M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Sawyer Jeffrey R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 20 1 none 1 2 2 35153200 90038800

Schoumacher Robert A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 29 1 none 1 2 2 35153200 90038800

Shaffrey Julie K. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Shah Namrata 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 13 1 none 1 2 2 35153200 90038800

Shearer Jack R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Shenep Jerry L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2I 1 none 1 2 2 35153200 90038800



























LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Shephard Claudette J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 16 1 >=16 1 2 2 35153200 90038800

Shive Stephanie H. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Shochat Stephen J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 1P 1 none 1 2 2 35153200 90038800

Shope Sheila E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Shulkin Barry L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Shurley William Robert 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 05 1 none 1 2 2 35153200 90038800

Simmons Andrea M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Smith Daniel E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Smithers Maureen A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 06 1 none 1 2 2 35153200 90038800

Snyder Angela 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Spunt Sheri L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Srinivasan Ashok 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Srinivasan Saumini 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 29 1 none 1 2 2 35153200 90038800

Stamps James Kevin 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Stewart David G. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 06 1 none 1 2 2 35153200 90038800

Stocks Rose Mary 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 04 1 none 1 2 2 35153200 90038800

Stokes Dennis C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 29 1 none 1 2 2 35153200 90038800

Strong Benjamin W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Stuart Walter Houston 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Sublette Nina K. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Sweeney Teresa A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Thompson Jerome W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 04 1 none 1 2 2 35153200 90038800

Thorne Joan 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Tomlinson Courtney W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Toothman Richard Lee 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800



























LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Triplett Brandon M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Trujillo Huaccho Luis A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 05 1 none 1 2 2 35153200 90038800

Tuomanen Elaine I. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Tutor James D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 29 1 none 1 2 2 35153200 90038800

Uytana Vinson L. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 30 1 none 1 2 2 35153200 90038800

Ver Halen Jon P. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 02 1 none 1 2 2 35153200 90038800

Viox Dale A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Walker Jessica Black 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Wallace Robert D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 24 1 none 1 2 2 35153200 90038800

Wallace (formerly FerrJennifer E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Waller Benjamin Rush 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 1D 1 none 1 2 2 35153200 90038800

Walton Robert C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Wang Winfred C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Ward Jewell C. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 65 22 1 none 1 2 2 35153200 90038800

Watson Andrew T. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 06 1 none 1 2 2 35153200 90038800

Webster Horace F. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Weiss Kenneth 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 20 1 none 1 2 2 35153200 90038800

Wetmore Cynthia J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Wetzel Glenn T. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 1D 1 none 1 2 2 35153200 90038800

Wheless James W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 13 1 none 1 2 2 35153200 90038800

White Francis R. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Whitten Ana E. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 05 1 none 1 2 2 35153200 90038800

Wilimas Judith A. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Wilson Matthew W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 18 1 none 1 2 2 35153200 90038800

Wodowski Karen S. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800



























LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Woods (formerly SwickTina M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Woody Kimberly D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Wright Becky B. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 05 1 none 1 2 2 35153200 90038800

Wright Karen D. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 37 1 <=18 1 2 2 35153200 90038800

Wyatt Robert J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 1K 1 none 1 2 2 35153200 90038800

Wynn Lynn W. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 78 08 1 >=18 1 2 2 35153200 90038800

Yarrow Sara H. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 91 05 1 none 1 2 2 35153200 90038800

Yates Amber M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 2H 1 none 1 2 2 35153200 90038800

Young Lisa J. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 06 1 none 1 2 2 35153200 90038800

Zafer Ghany M. 262 Danny thomas Place Mailstop 515 Memphis TN 38105 20 05 1 none 1 2 2 35153200 90038800LINCARE INC 114 HIGHWAY 51 N BATESVILLE MS 38606 40 54 1 none 1 1 2 34311871 89944047UNITED MEDICAL 2627 WEST OXFORD LOOP SUITE K OXFORD MS 38655 40 54 1 none 1 1 2 34366611 89571295LABCORP 1120 MAIN ST SOUTHAVEN MS 38671 20 30 1 none 1 1 2 34991992 90009852LINCARE PHARMACY SERVICES 1235 MAIN STREET SOUTHAVEN MS 38671 40 54 1 none 1 1 2 34991711 90011990A & A HOME HEALTH EQUIPMENT 221 HIGHWAY 1 S Greenville MS 38701 40 54 1 none 1 2 2 33405313 91038036Hanger Prosthetics & Orthotics Inc. 2331 Highway 1 South Greenville MS 38701 40 53 1 none 1 1 2 33355778 91041371UNITED MEDICAL 2339 HIGHWAY 1 SOUTH GREENVILLE MS 38701 40 54 1 none 1 1 2 33355576 91041389LINCARE INC 112 NORTH ST CLEVELAND MS 38732 40 54 1 none 1 1 2 33745137 90721987Apria Healthcare, Inc. 1794 Clif Gookin Blvd Tupelo MS 38801 40 54 1 none 1 1 2 34223719 88730309LINCARE INC 414 SOUTH GLOSTER SUITE B TUPELO MS 38801 40 54 1 none 1 1 2 34252041 88716333Hanger Prosthetics & Orthotics Inc. 502 Council Circle Tupelo MS 38801 40 53 1 none 1 1 2 34241281 88714552Hanger Prosthetics & Orthotics Inc. 3003 Highway 72 West Corinth MS 38834 40 53 1 none 1 1 2 34903900 88482600LINCARE INC 67 SUNSET DRIVE SUITE B GRENADA MS 38901 40 54 1 none 1 1 2 33768967 89801161Hanger Prosthetics & Orthotics Inc. 1603 Strong Avenue Suite A Greenwood MS 38930 40 53 1 none 1 1 2 33517009 90200276UNITED MEDICAL 146 HIGHWAY 12 WEST KOSCIUSKO MS 39090 40 54 1 none 1 1 2 33053400 89616200NATCHEZ COMMUNITY HOSPITAL 129 Jefferson Davis Blvd Natchez MS 39120 60 86 1 none 1 2 2 31523201 91388849NATCHEZ HMA PHYSICIAN MANAGEMENT Wright John MD 129 Jefferson Davis Blvd Suite A Natchez MS 39120 20 34 1 none 1 2 2 31523201 91388849NATCHEZ PEDIATRIC CLINIC Mabry Deana W. NP 136 Jefferson Davis Blvd Ste A Natchez MS 39120 78 79 1 >=18 1 2 2 31522862 91388422NATCHEZ PEDIATRIC CLINIC Russ Jennifer V. MD 136 Jefferson Davis Blvd Ste A Natchez MS 39120 20 37 1 <=18 1 2 1 31522862 91388422NATCHEZ PEDIATRIC CLINIC Weary Danita R. MD 136 Jefferson Davis Blvd Ste A Natchez MS 39120 20 37 1 <=18 1 2 1 31522862 91388422NATCHEZ HMA PHYSICIAN MANAGEMENT Akinwale Akinremi MD 150 Jefferson Davis Blvd Suite 130 Natchez MS 39120 20 41 1 >=18 1 2 2 31522972 91388080NATCHEZ HMA PHYSICIAN MANAGEMENT Dawkins Walter MD 150 Jefferson Davis Blvd Suite 130 Natchez MS 39120 20 08 1 none 1 2 2 31522972 91388080NATCHEZ HMA PHYSICIAN MANAGEMENT Jeansonne Richard MD 150 Jefferson Davis Blvd Suite 130 Natchez MS 39120 20 08 1 none 1 2 2 31522972 91388080NATCHEZ HMA PHYSICIAN MANAGEMENT Darg Quinones Ruth G. MD 150 Jefferson Davis Blvd. Suite 130 Natchez MS 39120 20 08 1 none 1 2 2 31522972 91388080NATCHEZ HMA PHYSICIAN MANAGEMENT Patel Jayeshkumar A. MD 150 Jefferson Davis Blvd. Suite 110 Natchez MS 39120 20 02 1 none 1 2 2 31522972 91388080NATCHEZ HMA PHYSICIAN MANAGEMENT Traina Jeffrey MD 150 Jefferson Davis Blvd. Suite 100 Natchez MS 39120 20 20 1 none 1 2 2 31522972 91388080NATCHEZ HMA PHYSICIAN MANAGEMENT Waller Angela NP 150 Jefferson Davis Blvd. Suite 130 Natchez MS 39120 78 08 1 none 1 2 2 31522972 91388080HANGER PROSTHETICS AND ORTHOTICS 304 Highland Blvd Ste C Natchez MS 39120 40 53 1 none 1 2 1 31521243 91400063JAMES R. TODD JR. MD Todd, Jr. James R. MD 500 M L King Street Natchez MS 39120 20 02 1 none 1 2 2 31565056 91389967PRECISION RADIOLOGY MANAGEMENT 54 Seargent Prentiss Dr Natchez MS 39120 20 30 1 none 1 2 2 31531985 91383965












LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

OPEN AIR MRI OF MSLOU 54 Seargent S. Prentiss Dr. Ste. 100 Natchez MS 39120 20 30 1 none 1 2 2 31531985 91383965UNITED MEDICAL 571 NORTH HIGHWAY 61 NATCHEZ MS 39120 40 54 1 none 1 1 2 31566917 91341179Doherty Vision Clinic, PA Doherty Patrick R. OD 611 Franklin Street Natchez MS 39120 28 88 1 none 1 2 2 31559766 91400393Doherty Vision Clinic, PA Doherty Shawn P. OD 611 Franklin Street Natchez MS 39120 28 88 1 none 1 2 2 31559766 91400393Hanger Prosthetics & Orthotics Inc. 1111 North Frontage Road Vicksburg MS 39180 40 53 1 none 1 1 2 32317088 90882859THE VISION CLINIC Ashley William S. OD 1808 Mission 66 Vicksburg MS 39180 28 88 1 none 1 2 2 32341250 90864456VICKSBURG HMA PHYSICIAN MANAGEMENT LLC Banks Michelle NP 2080 South Frontage Rd 1 20 Vicksburg MS 39180 78 08 1 none 1 2 2 32305294 90847728VICKSBURG HMA PHYSICIAN MANAGEMENT LLC Craft Brandon NP 2080 South Frontage Rd 1 20 Vicksburg MS 39180 78 79 1 >=18 1 2 2 32305294 90847728VICKSBURG HMA PHYSICIAN MANAGEMENT LLC Dare Daniel MD 2080 South Frontage Rd 1 20 Vicksburg MS 39180 20 20 1 none 1 2 2 32305294 90847728VICKSBURG HMA PHYSICIAN MANAGEMENT LLC Dorion Whitney NP 2080 South Frontage Rd 1 20 Vicksburg MS 39180 78 79 1 >=18 1 2 2 32305294 90847728VICKSBURG HMA PHYSICIAN MANAGEMENT LLC Edney Daniel MD 2080 South Frontage Rd 1 20 Vicksburg MS 39180 20 41 1 >=18 1 2 2 32305294 90847728VICKSBURG HMA PHYSICIAN MANAGEMENT LLC Fagan John MD 2080 South Frontage Rd 1 20 Vicksburg MS 39180 20 34 1 none 1 2 2 32305294 90847728VICKSBURG HMA PHYSICIAN MANAGEMENT LLC Griffin Denesia NP 2080 South Frontage Rd 1 20 Vicksburg MS 39180 78 08 1 none 1 2 2 32305294 90847728VICKSBURG HMA PHYSICIAN MANAGEMENT LLC Pierce Paul MD 2080 South Frontage Rd 1 20 Vicksburg MS 39180 20 41 1 >=18 1 2 2 32305294 90847728VICKSBURG HMA PHYSICIAN MANAGEMENT LLC Tribble Anita MD 2080 South Frontage Rd 1 20 Vicksburg MS 39180 20 41 1 >=18 1 2 2 32305294 90847728VICKSBURG HMA PHYSICIAN MANAGEMENT LLC Vinchwater Michelle NP 2080 South Frontage Rd 1 20 Vicksburg MS 39180 78 79 1 >=18 1 2 2 32305294 90847728UNITED MEDICAL 105 THALWEG DR SUITE B VICKSBURG MS 39183 40 54 1 none 1 1 2 32480500 91014100LABCORP 1860 CHADWICK DR STE 102 JACKSON MS 39204 20 30 1 none 1 1 2 32287071 90256636LINCARE INC 140 BUSINESS CENTER PKWY SUITE A PEARL MS 39208 40 54 1 none 1 1 2 32234800 90043700Apria Healthcare, Inc. 181 Davis Johnson Dr Ste D Richland MS 39218 40 54 1 none 1 1 2 32252252 90158456LINCARE INC 2001 AIRPORT ROAD SUITE 207 FLOWOOD MS 39232 40 54 1 none 1 1 2 32307209 90073370LABCORP/DYNACARE 1031 N FLOWOOD DR JACKSON MS 39232 20 30 1 none 1 1 2 32330563 90102724Hanger Prosthetics & Orthotics Inc. 15 River Bend Place Suite B Jackson MS 39232 40 53 1 none 1 1 2 32329892 90125332Hanger Prosthetics & Orthotics Inc. 1500-B 14th Stret Meridian MS 39301 40 53 1 none 1 1 2 32370957 88693662LINCARE INC 500 17TH STREET MERIDIAN MS 39301 40 54 1 none 1 1 2 32374385 88683268LABCORP 606 22ND AVE S MERIDIAN MS 39301 20 30 1 none 1 1 2 32357054 88693830LINCARE INC 500 CAMPBELL LOOP SUITE 50 HATTIESBURG MS 39401 40 54 1 none 1 1 2 31350387 89349196Apria Healthcare, Inc. 5912 US Highway 49 #C1 Hattiesburg MS 39401 40 54 1 none 1 1 2 31311778 89320947Hanger Prosthetics & Orthotics Inc. 1104 S 28th Avenue Hattiesburg MS 39402 40 53 1 none 1 1 2 31305817 89330981LABCORP 1110 W 1ST AVE ST LAUREL MS 39440 20 30 1 none 1 1 2 31709497 89126220ACORN PEDIATRICS PC Bologun Abiodun F. MD 1016 6th Ave Ste. A Picayune MS 39466 20 37 1 <=18 1 2 2 30530404 89690366BLOUNT III JAMES J MD Blount, III James J. MD 517 Fifth Ave Picayune MS 39466 20 16 1 none 1 2 2 30529854 89684230ALY - JEAN PIERRE, CYNTHIA V MD Jean-Pierre Cynthia V. MD 517 Fifth Avenue Picayune MS 39466 20 16 1 >=16 1 2 2 30529854 89684230LABCORP 1110 BROAD AVE Ste. 300 GULFPORT MS 39501 20 30 1 none 1 1 2 30364265 89115690Quest Diagnostics 1203 Broad Ave Suite C Gulfport MS 39501 20 30 1 none 1 1 2 30365311 89116713Hanger Prosthetics & Orthotics Inc. 1302 44th Avenue Gulfport MS 39501 40 53 1 none 1 1 2 30367497 89113541LINCARE INC 14231 SEAWAY ROAD STE D2 AND D3 GULFPORT MS 39503 40 54 1 none 1 1 2 30434189 89080292TUHC PHYSICIAN GROUP, LLC BENNETT James MD 15190 Community Road Suite 250 Gulfport MS 39503 20 20 1 none 1 1 2 30442146 89092923GARDEN PARK HOSPITAL 15200 Community Rd. Gulfport MS 39503 60 86 1 none 1 1 2 30442144 89093125TUHC PHYSICIAN GROUP, LLC CHRISENTERY-SINGLE Tammuella MD TBA Gulfport MS 39503 20 2H 1 none 1 1 2 30427887 89097943TUHC PHYSICIAN GROUP, LLC WASHKO Julie MD TBA Gulfport MS 39503 20 2H 1 none 1 1 2 30427887 89097943Apria Healthcare, Inc. 2198 Pass Rd Biloxi MS 39531 40 54 1 none 1 1 2 30402623 88966079LABCORP 4211 HOSPITAL ST STE 106 PASCAGOULA MS 39581 20 30 1 none 1 1 2 30374403 88534931UNITED MEDICAL 103 WHITEBROOK DR BROOKHAVEN MS 39601 40 54 1 none 1 1 2 31578100 90442800DIXON WILLIAM N. MD Dixon William N. 1311 Aston Ave. McComb MS 39648 20 02 1 none 1 2 2 31249983 90468067WILLIAMS STEVEN C. MD Williams Steven C. 1311 Aston Ave. McComb MS 39648 20 02 1 none 1 2 2 31249983 90468067Advanced Laparoscopic Surgery of South West MS, PLLC McGraw Patrick T. 1311 Aston Avenue McComb MS 39648 20 02 1 none 1 2 2 31249983 90468067JERKINS GREGORY L MD Jerkins Gregory 205 Marion Ave. McComb MS 39648 20 16 1 >=16 1 2 2 31249683 90474223JERKINS GREGORY L MD Nobles James 205 Marion Ave. McComb MS 39648 20 16 1 >=16 1 2 2 31249683 90474223JERKINS GREGORY L MD Remley Brian 205 Marion Ave. McComb MS 39648 20 16 1 >=16 1 2 2 31249683 90474223


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

JERKINS GREGORY L MD Sumrall Deborah 205 Marion Ave. McComb MS 39648 20 16 1 >=16 1 2 2 31249683 90474223AUSTIN WILLIAM K MD Austin William K. MD 215 Marion Avenue McComb MS 39648 20 04 1 none 1 2 2 31249862 90474136AUSTIN WILLIAM K MD Austin William K. MD 405 Marion Avenue McComb MS 39648 20 04 1 none 1 2 2 31253382 90472261AUSTIN WILLIAM K MD Harden Heather J. 405 Marion Avenue McComb MS 39648 78 08 1 none 1 2 2 31253382 90472261AUSTIN WILLIAM K MD Lewis Terrilyn L. 405 Marion Avenue McComb MS 39648 78 08 1 none 1 2 2 31253382 90472261NICHOLS III AUBREY N MD Nichols Aubrey N. MD 414 B Marion Ave McComb MS 39648 20 18 1 none 1 2 2 31237440 90466631BEACHAM MEMORIAL HOSPITAL 205 N. Cherry St Magnolia MS 39652 60 86 1 none 1 2 2 31145410 90459574WOODVILLE HOME HEALTH SERV 451 Bank Street Woodville MS 39669 40 54 1 none 1 2 2 31102990 91297767LINCARE INC 118 S MCCRARY RD SUITE 114 COLUMBUS MS 39702 40 54 1 none 1 1 2 33494976 88380673LABCORP 3543 BLUECUTT RD COLUMBUS MS 39705 20 30 1 none 1 1 2 33537989 88436157Hanger Prosthetics & Orthotics Inc. 100 Brandon Road Suite D Starkville MS 39759 40 53 1 none 1 1 2 33473759 88821651UNITED MEDICAL 217 WEST BROAD STREET WEST POINT MS 39773 40 54 1 none 1 1 2 33604644 88652069EMPI, INC. 599 Cardigan Rd St. Paul MN 55126 40 54 1 none 1 2 2 45049614 93123192JEFFREY SINGER MD Singer Jeffrey H. MD 4720 South I-10 Service Suite 406 Metaire LA 70001 20 18 1 none 1 2 2 29995808 90182225VASCULAR ACCESS CTR OF NEW ORLEANS Gardner Philip MD 1 Galleria Blvd Ste 110 Metairie LA 70001 20 02 1 >=18 1 2 2 29992362 90152618VASCULAR ACCESS CTR OF NEW ORLEANS McGurkin James MD 1 Galleria Blvd Ste 110 Metairie LA 70001 20 30 1 >=16 1 2 2 29992362 90152618VASCULAR ACCESS CTR OF NEW ORLEANS Sanger Matthew MD 1 Galleria Blvd Ste 110 Metairie LA 70001 20 41 1 >=18 1 2 2 29992362 90152618VASCULAR ACCESS CTR OF NEW ORLEANS Smith Kyle DO 1 Galleria Blvd Ste 110 Metairie LA 70001 19 41 1 >=16 1 2 2 29992362 90152618OPEN SIDED MRI OF NEW ORLEANS Dietz Thompson M. 1 Galleria Blvd. Ste. 715 Metairie LA 70001 20 30 1 none 1 2 2 29992362 90152618OPEN SIDED MRI OF NEW ORLEANS Tuazon Jaime S. MD 1 Galleria Blvd. Metairie LA 70001 20 30 1 none 1 2 2 29992362 90152618THE PHYSICIAN'S ALLIANCE CORP (TPAC) Post Robert M. 111 N. Causeway Blvd. Metairie LA 70001 20 08 1 none 1 2 2 29975121 90155257JEFFERSON ORTHOPEDIC APPL 1612 Clearview Parkway Metairie LA 70001 40 53 1 none 1 2 2 29989429 90181167FLEUR DE LIS COMMUNITY HEALTH OB GYN Jeanfreau Susan G. MD 3040 33rd Street Metairie LA 70001 20 16 1 >=16 1 2 2 29995392 90153244FLEUR DE LIS COMMUNITY HEALTH OB GYN Ryan Thomas B. MD 3040 33rd Street Metairie LA 70001 20 16 1 >=16 1 2 1 29995392 90153244BAYOU ORTHOTIC & PROSTHETIC CENTER 400 N. Causeway Blvd Metairie LA 70001 40 53 1 none 1 2 1 29977468 90156612

4621 W. Napoleon Avenue Suite 200 Metairie LA 70001 40 54 1 none 1 2 2 29994268 90183264JEFFREY SINGER MD Gillen Sharon MD 4704 Veterans Blvd Suite 406 Metairie LA 70001 20 18 1 none 1 2 2 29975706 90158356OBGYN BILLING LLC Graham Michael E. MD 4720 S. I-10 Service Rd. #104 Metairie LA 70001 20 16 1 >=16 1 2 1 29995808 90182225TUHC PHYSICIAN GROUP, LLC CONRAD Tracy DO 4720 S. I-10 Service Road Suite 101 Metairie LA 70001 19 41 1 none 1 1 2 29995808 90182225TUHC PHYSICIAN GROUP, LLC EVERS Patrice MD 4720 S. I-10 Service Road Suite 501 Metairie LA 70001 20 37 1 none 1 1 2 29995808 90182225LAKESIDE WOMENS SERVICES, LLC GRACE Amy MD 4720 S. I-10 Service Road Suite 205 Metairie LA 70001 20 16 1 none 1 1 2 29995808 90182225TUHC PHYSICIAN GROUP, LLC JONES Steven MD 4720 S. I-10 Service Road Suite 100 Metairie LA 70001 20 02 1 none 1 1 2 29995808 90182225DECK JR ROBERT EMD Deck Robert E. MD 4720 S. I-10 Svc. Rd. #206 Metairie LA 70001 20 16 1 >=16 1 2 1 29995808 90182225JEFFREY SINGER MD Brint Stephen F. MD, FACS 4720 South I-10 Service Suite 406 Metairie LA 70001 20 18 1 none 1 2 2 29995808 90182225JEFFREY SINGER MD D'Antonio M. Christine MD 4720 South I-10 Service Road Suite 406 Metairie LA 70001 20 18 1 none 1 2 2 29995808 90182225JEFFREY SINGER MD Gillen Sharon MD 4720 South I-10 Service Road Suite 103 Metairie LA 70001 20 18 1 none 1 2 2 29995808 90182225Quest Diagnostics 4770 S I 10 Service Rd W Suite 210 Metairie LA 70001 20 30 1 none 1 1 2 29995664 90182079COLON LISA M MD Colon Lisa M. MD, FACOG 4770 S. I-10 Service Rd Ste 104 Metairie LA 70001 20 16 1 >=16 1 2 1 29995664 90182079

5225 O'Donovan Dr. Ste 101 Metairie LA 70001 40 54 1 none 1 2 2 29977488 90178888Ochsner Clinic Area Leandro C. 2005 Veterans Memorial Blvd. Metairie LA 70002 20 08 1 None 1 2 2 30002496 90145372Ochsner Clinic Bardot Stephen F. 2005 Veterans Memorial Blvd. Metairie LA 70002 20 34 1 none 1 2 2 30002496 90145372Ochsner Clinic Berner Tara G. 2005 Veterans Memorial Blvd. Metairie LA 70002 20 08 1 None 1 2 2 30002496 90145372Ochsner Clinic Brown P. William 2005 Veterans Memorial Blvd. Metairie LA 70002 20 41 1 >=18 1 2 2 30002496 90145372Ochsner Clinic Conway James D. 2005 Veterans Memorial Blvd. Metairie LA 70002 20 41 1 >=18 1 2 2 30002496 90145372Ochsner Clinic Green Dwight A. 2005 Veterans Memorial Blvd. Metairie LA 70002 20 41 1 >=18 1 2 2 30002496 90145372Ochsner Clinic Kasparek JoEllen Plunkett PT 2005 Veterans Memorial Blvd. Metairie LA 70002 20 41 1 >=18 1 2 2 30002496 90145372Ochsner Clinic Montegudo Jessica R. PT 2005 Veterans Memorial Blvd. Metairie LA 70002 20 41 1 >=18 1 2 2 30002496 90145372Ochsner Clinic Olivier Sherise R. 2005 Veterans Memorial Blvd. Metairie LA 70002 20 08 1 None 1 2 2 30002496 90145372

THE INFUSION NETWORK OF LOUISIANA, INC. dba CarePoint Partners

THE INFUSION NETWORK OF LOUISIANA, INC. dba CarePoint Partners


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Patterson John T. 2005 Veterans Memorial Blvd. Metairie LA 70002 20 41 1 >=18 1 2 2 30002496 90145372Ochsner Clinic Puente Dawn M. 2005 Veterans Memorial Blvd. Metairie LA 70002 20 41 1 >=18 1 2 2 30002496 90145372Ochsner Clinic Vial Stacey M. 2005 Veterans Memorial Blvd. Metairie LA 70002 20 41 1 >=18 1 2 2 30002496 90145372SOUTHERN REHAB & HOME MEDICAL CTR 2615 Edenborn Ave. Suite A Metairie LA 70002 40 54 1 none 1 2 1 29999771 90162125THE PHYSICIAN'S ALLIANCE CORP (TPAC) Couret Leland 3000 Severn Avenue Suite 7 Metairie LA 70002 35 65 1 none 1 2 2 30005909 90159615THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cusimano Gabrielle 3000 Severn Avenue Suite 7 Metairie LA 70002 35 65 1 none 1 2 2 30005909 90159615BREATHING CARE MEDICAL 3100 5th St. Metairie LA 70002 40 54 1 none 1 2 1 30018528 90153166OCHSNER DURABLE MEDICAL EQUIPMENT 3211 N. Causeway Blvd. Metairie LA 70002 40 54 1 none 1 2 2 30008008 90154653FOOT SOLUTIONS 3213 17th St Metairie LA 70002 40 54 1 >=18 1 2 2 30009323 90155630THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schneider David L. 3225 Danny Park Suite 320 Metairie LA 70002 20 03 1 none 1 2 1 30002910 90170893DAVID L. SCHNEIDER, MD APMC Schneider David L. MD 3225 Danny Park #100 Metairie LA 70002 20 03 1 none 1 2 1 30002910 90170893PCG MEDICAL LLC 3350 Ridgelake Dr Ste 200 Metairie LA 70002 40 54 1 none 1 2 1 30010227 90153481PCG MEDICAL LLC 3350 Ridgelake Dr Ste 280 Metairie LA 70002 40 54 1 none 1 2 1 30010227 90153481PRN MEDICAL SERVICES LLC 3350 Ridgelake Dr Ste 292 Metairie LA 70002 40 54 1 none 1 2 2 30010227 90153481Xpress Ray Xpress Ray 3400 Division St Metairie LA 70002 25 30 1 None 2 1 2 30005363 90164722ELMWOOD MRI LTD 3400 Division St. Metairie LA 70002 20 30 1 none 1 2 2 30005363 90164722THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nicotri, Jr. Thomas 3421 N Causeway Ste 202 Metairie LA 70002 20 22 1 none 1 2 2 30010528 90154610THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schmidt Brian DPM 3510 Severn Ave Metairie LA 70002 32 48 1 none 1 2 2 30012821 90159335Steven A Scalco MD Scalco Steven A MD 3812 Ridgelake Dr Ste 2B Metairie LA 70002 20 17 1 None 2 1 2 30017476 90153184HEALTH MANAGEMENT SERVICES Inc 3828 Veterans Memorial Blvd Suite 201 Metairie LA 70002 40 54 1 none 1 2 2 30003791 90169543Quest Diagnostics 3908 Veterans Memorial Blvd Metairie LA 70002 20 30 1 none 1 1 2 30004030 90173169ACCESS RESPIRATORY HOMECARE L 4031 Veterans Memorial Blvd Metairie LA 70002 40 54 1 none 1 2 1 30004902 90175495AUDIBEL HEARING HEALTHCARE 4141 Veterans Memorial #210 Metairie LA 70002 34 64 1 none 1 2 2 30005041 90177732MAGNUM MEDICAL Hyman Alvin 4323 Division St Ste 209 Metairie LA 70002 40 54 1 none 1 2 2 30013324 90164496THE PHYSICIAN'S ALLIANCE CORP (TPAC) Scully, Jr. Cyril 3510 Severn Ave Metarie LA 70002 32 48 1 none 1 2 2 30012821 90159335THE PHYSICIAN'S ALLIANCE CORP (TPAC) Burris Debra 110 Veterans Blvd #105 Metairie LA 70005 20 13 1 none 1 2 2 29999825 90123924POOLE DERMATOLOGY APMC Haseltine Mara A. MD 111 Veterans Blvd. Suite 406 Metairie LA 70005 20 07 1 >=18 1 2 2 30000291 90123873POOLE DERMATOLOGY APMC Poole Jeffery C. MD 111 Veterans Blvd. Suite 406 Metairie LA 70005 20 07 1 none 1 2 1 30000291 90123873HOOD MARY E OD Hood Mary E. OD 1431 Veterans Blvd Metairie LA 70005 28 88 1 none 1 2 2 30002167 90138929VITAL LINK, A HOME CARE COMPANY 401 Veterans Blvd. Suite 205 Metairie LA 70005 44 75 1 none 1 2 2 30001181 90126671THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guichard Darek 401 Veterans Memorial Hwy Ste 207 Metairie LA 70005 32 48 1 none 1 2 2 30001181 90126671DIMITRI EYE CARE Dimitri George J. MD 701 Metairie Rd Metairie LA 70005 20 18 1 none 1 2 1 29987604 90130307THE PHYSICIAN'S ALLIANCE CORP (TPAC) Myers David 701 Metairie Rd Suite 2a 202 Metairie LA 70005 20 41 1 >=18 1 2 2 29987604 90130307DIMITRI EYE CARE Prouet, Jr. Paul E. OD 701 Metairie Rd Metairie LA 70005 20 18 1 none 1 2 1 29987604 90130307DIMITRI EYE CARE Dimitri Ronald OD 701 Metairie Rd. Metairie LA 70005 28 88 1 none 1 2 2 29987604 90130307THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ware David 701 Metairie Road 1a-202 Metairie LA 70005 35 65 1 none 1 2 2 29987604 90130307THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rivera Miguel P. 3020 Kingman St Metairie LA 70006 20 2E 1 none 1 2 2 30001949 90180275THE PHYSICIAN'S ALLIANCE CORP (TPAC) Montalvo Hector 3020 Kingman Street Metairie LA 70006 20 41 1 >=18 1 2 2 30001949 90180275CANTILEVER SHOE STORE 3427 Houma Blvd Metairie LA 70006 40 53 1 none 1 2 2 30005981 90179764SHEEN ALAN E MD Sheen Alan E. MD 3701 Houma Blvd Ste 101 Metairie LA 70006 20 03 1 none 1 2 1 30008932 90180262THE PHYSICIAN'S ALLIANCE CORP (TPAC) Palm Michael 3717 Houma Blvd Suite 200 Metairie LA 70006 91 05 1 none 1 2 1 30009072 90180288THE PHYSICIAN'S ALLIANCE CORP (TPAC) Washington Dartain 3717 Houma Blvd Suite 200 Metairie LA 70006 91 05 1 none 1 2 1 30009072 90180288THE PHYSICIAN'S ALLIANCE CORP (TPAC) Carradine John 3800 Houma Blvd Suite 260 Metairie LA 70006 32 48 1 none 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jeanfreau Robert J. 3800 Houma Blvd Ste 335 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jeanfreau Wallace E. 3800 Houma Blvd Ste 335 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Monte Frank 3800 Houma Blvd Suite 230 Metairie LA 70006 20 08 1 None 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Parikh Parimal 3800 Houma Blvd Suite #308 Metairie LA 70006 20 41 1 >=18 1 2 1 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rogers James A. 3800 Houma Blvd Suite 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Romaguera Pedro 3800 Houma Blvd Suite 350 Metairie LA 70006 20 41 1 >=18 1 2 1 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sampognaro, III Joseph 3800 Houma Blvd # 230 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Angelico Blaise 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Collins Bradley 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dantagnan Frederick 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Finney, III John 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Glorioso Monty 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Levy Lawrence 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lupin Arnold 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mazoue Clayton 3800 Houma Blvd Ste 325 Metairie LA 70006 20 08 1 None 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Naccari Brian 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Parker Clevis 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pollock Robert 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Raymond Sidney 3800 Houma Blvd Ste 325 Metairie LA 70006 20 41 1 >=18 1 2 2 30010291 90180827PEDRO ROMAGUERA, APMC Romaguera Pedro MD 3800 Houma Blvd. Ste 350 Metairie LA 70006 20 41 1 >=16 1 2 1 30010291 90180827THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barrilleaux Christopher N. 3860 Houma Blvd Suite 220 Metairie LA 70006 20 10 1 none 1 2 2 30010707 90180903THE PHYSICIAN'S ALLIANCE CORP (TPAC) Harrington John 3860 Houma Blvd Suite 226 Metairie LA 70006 20 10 1 none 1 2 2 30010707 90180903THE PHYSICIAN'S ALLIANCE CORP (TPAC) Miller, Jr. Harold 3901 Houma Blvd Ste 103 Metairie LA 70006 20 41 1 >=18 1 2 2 30011037 90180645THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tran Tuan-huy 3901 Houma Blvd Ste 103 Metairie LA 70006 20 2E 1 none 1 2 2 30011037 90180645THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wise Jonathan 3901 Houma Blvd Ste 103 Metairie LA 70006 20 2E 1 none 1 2 2 30011037 90180645NEW ORLEANS EYE SPECIALISTS Balkan Robert J. MD 3901 Houma Blvd Suite 216 Metairie LA 70006 20 18 1 none 1 2 1 30011037 90180645NEW ORLEANS EYE SPECIALISTS Hendricks Clifford A. MD 3901 Houma Blvd Suite 216 Metairie LA 70006 20 18 1 none 1 2 2 30011037 90180645NEW ORLEANS EYE SPECIALISTS Leader Barry J. 3901 Houma Blvd Suite 216 Metairie LA 70006 20 18 1 none 1 2 2 30011037 90180645CARE CONCEPTS LOUISIANA INC 3901 Houma Blvd Suite 308 Metairie LA 70006 40 54 1 none 1 2 2 30011037 90180645THE PHYSICIAN'S ALLIANCE CORP (TPAC) Burvant John 3939 Houma Blvd Bldg 6, Ste 201 Metairie LA 70006 20 20 1 none 1 2 2 30011301 90180695THE PHYSICIAN'S ALLIANCE CORP (TPAC) Garoutte John 3939 Houma Blvd Bldg 6, Ste 21 Metairie LA 70006 20 20 1 none 1 2 2 30011301 90180695THE PHYSICIAN'S ALLIANCE CORP (TPAC) Glovinsky Marc S. 3939 Houma Blvd Bldg 6 Ste 224 Metairie LA 70006 32 48 1 none 1 2 2 30011301 90180695THE PHYSICIAN'S ALLIANCE CORP (TPAC) Haddad, Jr Charles 3939 Houma Blvd Ste 21 Metairie LA 70006 20 20 1 none 1 2 2 30011301 90180695THE PHYSICIAN'S ALLIANCE CORP (TPAC) Montz John 3939 Houma Blvd Bldg 6, Ste 21 Metairie LA 70006 20 20 1 none 1 2 2 30011301 90180695THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ploger Wilmot 3939 Houma Blvd Bldg 6, Ste 21 Metairie LA 70006 20 20 1 none 1 2 2 30011301 90180695THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rooney James M. 3939 Houma Blvd Bldg 6 Ste 228 Metairie LA 70006 20 41 1 >=18 1 2 2 30011301 90180695THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sketchler Jeffrey 3939 Houma Blvd, #21 Metairie LA 70006 20 20 1 none 1 2 2 30011301 90180695THE PHYSICIAN'S ALLIANCE CORP (TPAC) Murphy Michael 3939 Houma Blvd.-dr Row #17 Metairie LA 70006 35 65 1 none 1 2 2 30002069 90185477THE PHYSICIAN'S ALLIANCE CORP (TPAC) Porche Edwin 3939 Houma Blvd.-dr Row #17 Metairie LA 70006 35 65 1 none 1 2 2 30002069 90185477THE PHYSICIAN'S ALLIANCE CORP (TPAC) Porche Robert 3939 Houma Blvd.-dr Row #17 Metairie LA 70006 35 65 1 none 1 2 2 30002069 90185477JEFFERSON RADIATION ONCOLOGY Padmanabha Siddhartha MD 4004 Houma Blvd Ste 211 Metairie LA 70006 20 2J 1 none 1 2 1 30024657 90198995PARISH ANESTHESIA OF JEFFERSON 4200 HOUMA BLVD METAIRIE LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Allen, Jr. Richard L. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Arcario Jane Ann CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Bacon Cheryl D. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Bandhu Kathleen E. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Baranovic Virginia C. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Barron Charlotte L. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Beaumont Stephen L. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Benfiglio, Jr. Frank J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Benner Regina F. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Bloodsworth, Jr. Charles E. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Borchardt Jeffrey A. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Boudeaux David M. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Branting Scott B. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Breaux, Jr. Timothy G. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Brennan Maureen T. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

PARISH ANESTHESIA OF JEFFERSON Brouillette Charlene V. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Broussard Courtney J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Broussard Mandy Lea CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Callaway Lauren M. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Callegari Arthur J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Carbajal Heather N. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Carey Susan B. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Carr Gail L. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Cazale Sandra W. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chau Ann C. 4200 Houma Blvd 4th Floor Metairie LA 70006 20 16 1 >=16 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Clement Cristin J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Cole Belinda H. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Comarda Neal G. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Cook Louise S. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Corn Michelle R. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Cougle Christopher A. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Dale Celeste A. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Dang Son M. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Davenport Julie J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Davenport, Jr. Charles W. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Delay Mary S. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Denny Terri CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Devlin, III Raymond J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Dudley Bobette CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dugan Fortune 4200 Houma Blvd 2nd Fl Metairie LA 70006 20 06 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Duhon Damain G. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Eagleton Bernard E. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Eaton William M. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Eckert Charles E. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Faessler Charlotte J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Falgoust Marian A. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Fish Brian J. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Freeman James C MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Friedrichs Joann T. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Fussell Howard M. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Galliano Dante J. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Gentry David C. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Gonzales Steve CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Grissom Brian CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Guichard Scott M. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Guidry Renee CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Henson Mark A. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Higgins, Jr. Thomas J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Holtzman, Jr. Alan M. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Hugel Julia G. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Inuru Jayachandra MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Johnson Laura A. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Jones Brandy S. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Kata Venkataswara R. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kelley Glenn 4200 Houma Blvd 2nd Fl Metairie LA 70006 20 06 1 none 1 2 2 30014517 90181717


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

PARISH ANESTHESIA OF JEFFERSON Kellum, Jr. Joseph L. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Landers Melissa S. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Landreneau Nason E. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Larocca Donna CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON LaSalle Elizabeth D. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON LeBlanc Myra C. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Ledet, Jr. Lloyd F. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Levin Louis W. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Lewis Matthew J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Lionnet Yvette B. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Lombard Jeffrey C. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Lopez Rodrigo A. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Madden Brendt S. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Maduell Stephen L. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Mallik Debashree CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Martin Jennifer B. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Mayronne Laura E. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON McCain Scott A. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Melancon, Jr. Dean J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717THE PHYSICIAN'S ALLIANCE CORP (TPAC) Menszer Gary 4200 Houma Blvd 2nd Fl Metairie LA 70006 20 06 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Mimeles Derek MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Monnat Paula M. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Moore Richard T. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Mumford Hal CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nuttli Thomas 4200 Houma Blvd 3rd Fl Metairie LA 70006 20 29 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON O'Blanc Kyle A. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON O'Neill Rosalinda G. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Palo Dana M. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Poirrier Amber J. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717THE PHYSICIAN'S ALLIANCE CORP (TPAC) Preis Lehman 4200 Houma Blvd 2nd Fl Metairie LA 70006 20 06 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Puneky Allison K. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Rosinia Francis A. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Sanchez Maria Del Carmen MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Sanders Scott Foster CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Schroeder Charles F. MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Seay Robert Keith CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Smith Brian Douglas CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Souife Keeva Aisha CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Tanner April Jenell CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Tortorich Frank CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Trainor, Jr. Patrick John CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Triay, III Melvin Louis MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Trosclair Chad Andrew CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Tummala Seshagirirao MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Weisdorffer Robert Louis CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON White Pamela Ann MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Williams Lynda Ann CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Young Cindy Blankenship CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 2 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Young Elizabeth Tracy MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 1 30014517 90181717PARISH ANESTHESIA OF JEFFERSON Zhang Lihua MD 4200 Houma Blvd Metairie LA 70006 20 05 1 none 1 2 2 30014517 90181717


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

PARISH ANESTHESIA OF JEFFERSON Zimmerman Christopher V. CRNA 4200 Houma Blvd Metairie LA 70006 91 05 1 none 1 2 1 30014517 90181717THE PHYSICIAN'S ALLIANCE CORP (TPAC) Linares Luis A. 4204 Houma Blvd Metairie LA 70006 20 2J 1 none 1 2 2 30014532 90181719THE PHYSICIAN'S ALLIANCE CORP (TPAC) Linares Luis A. 4204 Houma Blvd Metairie LA 70006 20 2J 1 none 1 2 2 30014532 90181719EAST JEFFERSON RADIATION ONCOLOGY Monsour Paul D. MD 4204 Houma Blvd Ste 100 Metairie LA 70006 20 2J 1 none 1 2 1 30014532 90181719JEFFERSON RADIATION ONCOLOGY Monsour Paul D. MD 4204 Houma Blvd Ste 211 Metairie LA 70006 20 2J 1 none 1 2 1 30014532 90181719EAST JEFFERSON RADIATION ONCOLOGY Padmanabha Siddhartha 4204 Houma Blvd Ste 100 Metairie LA 70006 20 2J 1 none 1 2 1 30014532 90181719EAST JEFFERSON RADIATION ONCOLOGY Page Paul N. MD 4204 Houma Blvd Ste 100 Metairie LA 70006 20 2J 1 none 1 2 2 30014532 90181719JEFFERSON RADIATION ONCOLOGY Page Paul N. MD 4204 Houma Blvd Ste 211 Metairie LA 70006 20 2J 1 none 1 2 2 30014532 90181719THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bourgeois Roland 4224 Houma Blvd Ste 500 Metairie LA 70006 20 06 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Contreary Kelvin J 4224 Houma Blvd Ste 310 Metairie LA 70006 20 02 1 none 1 2 1 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Deboisblanc Rene 4224 Houma Blvd Suite 310 Metairie LA 70006 20 02 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Deffer Orlando 4224 Houma Blvd Ste 500 Metairie LA 70006 20 06 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Eiswirth Clement 4224 Houma Blvd Ste 500 Metairie LA 70006 20 06 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ilgenfritz Burr 4224 Houma Blvd Suite 640 Metairie LA 70006 20 04 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mailander Lois 4224 Houma Blvd Ste 500 Metairie LA 70006 20 06 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morgan Rollin 4224 Houma Blvd Suite 420 Metairie LA 70006 20 41 1 >=18 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pappas Nicholas D. 4224 Houma Blvd Ste 500 Metairie LA 70006 20 06 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rolston William 4224 Houma Blvd Suite 450a Metairie LA 70006 20 06 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tilton Gregory D. 4224 Houma Blvd Suite 500 Metairie LA 70006 20 06 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Uddo Joseph 4224 Houma Blvd Ste 450 Metairie LA 70006 20 02 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Veith Robert 4224 Houma Blvd #220 Metairie LA 70006 20 2H 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Velez Robert J. 4224 Houma Blvd Ste 350 Metairie LA 70006 20 02 1 none 1 2 2 30014606 90181732THE PHYSICIAN'S ALLIANCE CORP (TPAC) Worley Newland 4224 Houma Blvd Suite 640 Metairie LA 70006 20 04 1 none 1 2 2 30014606 90181732GULF SOUTH EYE ASSOCIATES Boyle, IV John W. MD 4224 Houma Blvd Ste 100 Metairie LA 70006 20 18 1 none 1 2 2 30014606 90181732GULF SOUTH EYE ASSOCIATES Sibley Riley C. MD 4224 Houma Blvd Ste 100 Metairie LA 70006 20 18 1 none 1 2 2 30014606 90181732ROBERT W VEITH MD LLC Veith Robert 4224 Houma Blvd. Suite 330 Metairie LA 70006 20 2H 1 none 1 2 2 30014606 90181732GULF SOUTH EYE ASSOCIATES Fitzmorris Catherine T. MD 4224 Houma Blvd. Ste 100 Ste 100 Metairie LA 70006 20 18 1 none 1 2 2 30014606 90181732ROBERT D ROSS MD APMC Ross Robert D. MD, FACS 4224 Houma Blvd., Ste. 430 Ste. 430 Metairie LA 70006 20 18 1 none 1 2 1 30014606 90181732WOMENS CANCER CARE Ashton Lisa 4228 Houma Blvd Ste 130 Metairie LA 70006 78 08 1 None 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Black Marcus 4228 Houma Blvd Suite 130 Metairie LA 70006 20 2H 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bleich Stanley 4228 Houma Blvd Suite 530 Metairie LA 70006 20 06 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boyd Clay N. 4228 Houma Blvd Suite 600a Metairie LA 70006 20 34 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brenner Howard 4228 Houma Blvd Suite 520 Metairie LA 70006 20 10 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brothers Michael 4228 Houma Blvd Ste 300 Metairie LA 70006 20 33 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Casey Lisa 4228 Houma Blvd Ste 330 Metairie LA 70006 20 08 1 None 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Catinis Georges E. 4228 Houma Blvd Suite 520 Metairie LA 70006 20 10 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Champlin Stephen 4228 Houma Blvd Ste 410 Metairie LA 70006 20 16 1 >=16 1 2 1 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chermansky Christopher J. 4228 Houma Blvd Suite 600a Metairie LA 70006 20 34 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chesson Ralph R. 4228 Houma Blvd Suite 600a Metairie LA 70006 20 16 1 >=16 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Collins Sean M. 4228 Houma Blvd Ste 330 Metairie LA 70006 20 34 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cosgriff Thomas 4228 Houma Blvd Ste 130 Metairie LA 70006 20 2H 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cucchiara Charles 4228 Houma Blvd Ste 330 Metairie LA 70006 20 08 1 None 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Euans David 4228 Houma Blvd Ste 330 Metairie LA 70006 20 08 1 None 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gold Melvin 4228 Houma Blvd Suite 520 Metairie LA 70006 20 10 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hevron John 4228 Houma Blvd Ste 410 Metairie LA 70006 20 16 1 >=16 1 2 1 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hoerner David 4228 Houma Blvd Ste 410 Metairie LA 70006 20 16 1 >=16 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ibeanu Okechukwu A 4228 Houma Blvd Suite 600a Metairie LA 70006 20 16 1 >=16 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kennedy Thomas 4228 Houma Blvd Ste 410 Metairie LA 70006 20 16 1 >=16 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lacour Stephen M. 4228 Houma Blvd Suite 600a Metairie LA 70006 20 34 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Levy, III Walter 4228 Houma Blvd Ste 310 Metairie LA 70006 20 34 1 none 1 2 2 30014621 90181735


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lonseth Eric 4228 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lundgren Justin 4228 Houma Blvd Suite 510 Metairie LA 70006 35 65 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Magonet Gordon 4228 Houma Blvd Ste 330 Metairie LA 70006 20 08 1 None 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Malik Arshed P. 4228 Houma Blvd Suite 530 Metairie LA 70006 20 06 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meyers William M. 4228 Houma Blvd Suite 520 Metairie LA 70006 20 10 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nobles Bennie 4228 Houma Blvd Ste 410 Metairie LA 70006 20 16 1 >=16 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Paddock Richard 4228 Houma Blvd Ste 310 Metairie LA 70006 20 34 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Puente George R. 4228 Houma Blvd Suite 520 Metairie LA 70006 20 10 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rabin Ronald 4228 Houma Blvd Ste 310 Metairie LA 70006 20 34 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reiss Gary 4228 Houma Blvd Suite 520 Metairie LA 70006 20 10 1 none 1 2 1 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Roach Harry 4228 Houma Blvd Ste 300 Metairie LA 70006 20 33 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Russ John Kevin 4228 Houma Blvd Ste 330 Metairie LA 70006 20 08 1 None 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ryan Robert 4228 Houma Blvd Ste 330 Metairie LA 70006 20 08 1 None 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sonnier Scott A. 4228 Houma Blvd Suite 130 Metairie LA 70006 20 2H 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stokes Harold M. 4228 Houma Blvd Suite 600a Metairie LA 70006 20 02 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tubb James 4228 Houma Blvd Ste 300 Metairie LA 70006 20 33 1 none 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wegmann Mark 4228 Houma Blvd Ste 520 Metairie LA 70006 20 10 1 none 1 2 2 30014621 90181735Ochsner Clinic Winters J. Christian 4228 Houma Blvd Suite 600a Metairie LA 70006 20 34 1 none 1 2 2 30014621 90181735WOMENS CANCER CARE Braly Patricia S. MD, APMC 4228 Houma Blvd. Suite 130 Metairie LA 70006 20 16 1 >=16 1 2 2 30014621 90181735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bedestani Ahmet 4300 Houma Blvd Suite #203 Metairie LA 70006 20 16 1 >=16 1 2 2 30014888 90181782THE PHYSICIAN'S ALLIANCE CORP (TPAC) Blais Christopher M. 4300 Houma Blvd Ste 306 Metairie LA 70006 20 2I 1 none 1 2 2 30014888 90181782THE PHYSICIAN'S ALLIANCE CORP (TPAC) Failla Diane M. 4300 Houma Blvd Ste 306 Metairie LA 70006 20 2I 1 none 1 2 2 30014888 90181782THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hoxsey Rodney J. 4300 Houma Blvd Suite #203 Metairie LA 70006 20 16 1 >=16 1 2 2 30014888 90181782THE PHYSICIAN'S ALLIANCE CORP (TPAC) Maupin Robert T. 4300 Houma Blvd Suite #203 Metairie LA 70006 20 16 1 >=16 1 2 2 30014888 90181782THE PHYSICIAN'S ALLIANCE CORP (TPAC) Miller Joseph M. 4300 Houma Blvd Suite #203 Metairie LA 70006 20 16 1 >=16 1 2 2 30014888 90181782THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nolan Thomas E. 4300 Houma Blvd Suite #203 Metairie LA 70006 20 16 1 >=16 1 2 2 30014888 90181782THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rabito, Jr. Frank 4300 Houma Blvd Suite 306 Metairie LA 70006 20 2I 1 none 1 2 2 30014888 90181782LUIS F SOTO, MD Soto Luis F. MD 4300 Houma Blvd Ste 107 Metairie LA 70006 20 06 1 >=18 1 2 1 30014888 90181782THE PHYSICIAN'S ALLIANCE CORP (TPAC) Airhart Richard A. 4315 Houma Blvd Suite 400 Metairie LA 70006 20 34 1 none 1 2 2 30014997 90181308THE PHYSICIAN'S ALLIANCE CORP (TPAC) Debessonet David A. 4315 Houma Blvd Suite 400 Metairie LA 70006 20 34 1 none 1 2 2 30014997 90181308THE PHYSICIAN'S ALLIANCE CORP (TPAC) Eversmeyer Walter H. 4315 Houma Blvd Suite 303 Metairie LA 70006 20 2M 1 none 1 2 2 30014997 90181308THE PHYSICIAN'S ALLIANCE CORP (TPAC) Le Van T 4315 Houma Blvd Ste 501 Metairie LA 70006 20 41 1 >=18 1 2 2 30014997 90181308THE PHYSICIAN'S ALLIANCE CORP (TPAC) Zaveri Kiran G. 4315 Houma Blvd Ste 1 Metairie LA 70006 20 41 1 >=18 1 2 2 30014997 90181308THE PHYSICIAN'S ALLIANCE CORP (TPAC) Biundo, Jr. Joseph 4315 Houma Blvd Ste 303 Metairie LA 70006 20 2M 1 none 1 2 2 30014997 90181308PARISH ANESTHESIA OF JEFFERSON Allen, Jr. Richard Lonnie CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Arcario Jane Ann CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Bacon Cheryl D. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Bandhu Kathleen Eyer CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Baranovic Virginia Caire CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Barron Charlotte L. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Beaumont Stephen Lawrence CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Benfiglio, Jr. Frank Joseph CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Benner Regina Fracchia CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Bloodsworth, Jr. Charles Edward CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Borchardt Jeffrey A. MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Boudeaux David Michael CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Branting Scott Brian MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Breaux, Jr. Timothy Gerald CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Brennan Maureen Therese CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Brouillette Charlene V. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

PARISH ANESTHESIA OF JEFFERSON Broussard Courtney James CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Broussard Mandy Lea CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Callaway Lauren M. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Callegari Arthur J. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Carbajal Heather Nicole CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Carey Susan Beth MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Carr Gail LeMoine CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Cazale Sandra Williams CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Clement Cristin Joan CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Cole Belinda H. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Comarda Neal G. MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Cook Louise Segura CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Corn Michelle R. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Cougle Christopher Allan MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Dale Celeste A. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Dang Son Manh MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Davenport Julie Johnson CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Davenport, Jr. Charles William MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Delay Mary S. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Denny Terri CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Devlin, III Raymond J. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Dudley Bobette CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Duhon Damain Godfrey CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Eagleton Bernard E. MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Eaton William Michael MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Eckert Charles E. MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Faessler Charlotte J. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Falgoust Marian A. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Fish Brian James MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Freeman James Carlton MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Friedrichs Joann Tabary CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Fussell Howard Michael CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Galliano Dante Juan MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Gentry David Charles CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Gonzales Steve CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Grissom Brian CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Guichard Scott Michael CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Guidry Renee CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Henson Mark Alan MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Higgins, Jr. Thomas John CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Holtzman, Jr. Alan McKim CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Hugel Julia Goszczynski CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Inuru Jayachandra MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Johnson Laura A. MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Jones Brandy Simon CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Kata Venkataswara Rao MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Kellum, Jr. Joseph Leslie MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Landers Melissa Shreve CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Landreneau Nason Eric CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Larocca Donna CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795


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Age Restricti

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PARISH ANESTHESIA OF JEFFERSON LaSalle Elizabeth D'Antonio CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON LeBlanc Myra Crabtree CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Ledet, Jr. Lloyd Francis CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Levin Louis W. MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Lewis Matthew J. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Lionnet Yvette Bienvenu CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Lombard Jeffrey Charles CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Lopez Rodrigo Alejandro CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Madden Brendt Sticker CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Maduell Stephen Louis CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Mallik Debashree CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Martin Jennifer Bourgeios CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Mayronne Laura E. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON McCain Scott Anthony CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Melancon, Jr. Dean Jeffrey CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Mimeles Derek MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Monnat Paula M. MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Moore Richard Troy CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Mumford Hal CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON O'Blanc Kyle Anthony CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON O'Neill Rosalinda Garcia CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Palo Dana Melancon CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Poirrier Amber Judice CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Puneky Allison Kinton CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Rosinia Francis Anthony MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Sanchez Maria Del Carmen MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Sanders Scott Foster CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Schroeder Charles F. MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Seay Robert Keith CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Smith Brian Douglas CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Souife Keeva Aisha CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Tanner April Jenell CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Tortorich Frank CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Trainor, Jr. Patrick John CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Triay, III Melvin Louis MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Trosclair Chad Andrew CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Tummala Seshagirirao MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Weisdorffer Robert Louis CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON White Pamela Ann MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Williams Lynda Ann CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Young Cindy Blankenship CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Young Elizabeth Tracy MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 1 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Zhang Lihua MD 4320 Houma Blvd 5th Floor Metairie LA 70006 20 05 1 none 1 2 2 30014962 90181795PARISH ANESTHESIA OF JEFFERSON Zimmerman Christopher V. CRNA 4320 Houma Blvd 5th Floor Metairie LA 70006 91 05 1 none 1 2 1 30014962 90181795Eyecare Providers LLC dba Eyecare Associates Ayyala Ramesh S. MD 4324 Veterans Blvd., Ste. 102 Metairie LA 70006 20 18 1 none 1 2 1 30008627 90181982Eyecare Providers LLC dba Eyecare Associates Cerise Donald P. MD 4324 Veterans Blvd., Ste. 102 Metairie LA 70006 20 18 1 none 1 2 2 30008627 90181982Eyecare Providers LLC dba Eyecare Associates Landry Ronald A. MD 4324 Veterans Blvd., Ste. 102 Metairie LA 70006 20 18 1 none 1 2 2 30008627 90181982Eyecare Providers LLC dba Eyecare Associates McGinn, Jr. Thomas T. OD 4324 Veterans Blvd., Ste. 102 Metairie LA 70006 28 88 1 none 1 2 2 30008627 90181982Eyecare Providers LLC dba Eyecare Associates Perez William A. MD 4324 Veterans Blvd., Ste. 102 Metairie LA 70006 20 18 1 none 1 2 2 30008627 90181982Eyecare Providers LLC dba Eyecare Associates Stumpf, Jr. George C. OD 4324 Veterans Blvd., Ste. 102 Metairie LA 70006 28 88 1 none 1 2 2 30008627 90181982


LOI Contract STP*

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New Patient

Age Restricti

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Eyecare Providers LLC dba Eyecare Associates Sumich Leni T. MD 4324 Veterans Blvd., Ste. 102 Metairie LA 70006 20 18 1 none 1 2 2 30008627 90181982LABCORP 4330 LOVELAND ST, SUITE C METAIRIE LA 70006 20 30 1 none 1 1 2 30008555 90180870THE PHYSICIAN'S ALLIANCE CORP (TPAC) Harris Friedrichs 4409 Utica St Ste 100 Metairie LA 70006 20 2K 1 none 1 2 2 29999964 90180648THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kim Hui 4409 Utica St #100 Metairie LA 70006 20 2K 1 none 1 2 2 29999964 90180648THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lindberg Jill 4409 Utica St Ste 100 Metairie LA 70006 20 2K 1 none 1 2 2 29999964 90180648THE PHYSICIAN'S ALLIANCE CORP (TPAC) Molina Miguel 4409 Utica St #100 Metairie LA 70006 20 2K 1 none 1 2 2 29999964 90180648THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morris Steven 4409 Utica Street Suite 100 Metairie LA 70006 20 2K 1 none 1 2 2 29999964 90180648THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rodriguez Gabriel Rivera 4409 Utilca Street Suite 100 Metairie LA 70006 20 2K 1 none 1 2 2 30015086 90181296THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pippin Gregory W. 4421 Chastant Street Metairie LA 70006 20 24 1 none 1 2 2 30017832 90199782INFANT MEDICAL MONITORING LLC 4636 Sanford St., Ste. 199 Metairie LA 70006 40 54 1 none 1 2 1 30002032 90186085JEFFREY SINGER MD D'Antonio M. Christine MD 4704 Veterans Blvd Suite 103 Metairie LA 70006 20 18 1 none 1 2 2 30018366 90193025JEFFREY SINGER MD Brint Stephen F. MD, FACS 4704 Veterans Blvd, Suite 103 Metairie LA 70006 20 18 1 none 1 2 2 30013007 90182765JEFFREY SINGER MD Singer Jeffrey H. MD 4704 Veterans Blvd., Suite 103 Metairie LA 70006 20 18 1 none 1 2 2 30017953 90200048Ochsner Clinic Bronfin Daniel R. 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic Brown Samira L. 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic Busenlener Tanya S. 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic Calix Danielle M. 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic DeFusco Lisa M. 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic DePaula Alicia C. 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic Fielkow Susan K. PT 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic Glick Amy PT 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic Granier Patricia M. PT 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic Morris, IV George B. 4901 Veterans Memorial Blvd. Metairie LA 70006 20 16 1 >=16 1 2 1 30005996 90192897Ochsner Clinic Parise Angela M. 4901 Veterans Memorial Blvd. Metairie LA 70006 20 16 1 >=16 1 2 1 30005996 90192897Ochsner Clinic Seoane L. Michelle 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic Swain Katherine L. 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic Wasserman Michael F. PT 4901 Veterans Memorial Blvd. Metairie LA 70006 20 37 1 <=18 1 2 2 30005996 90192897Ochsner Clinic Rudolph Amanda 4901 Veterans Memorial Hwy. Metairie LA 70006 78 79 1 >=18 1 2 2 30005996 90192897Ochsner Clinic Tigert Nancy 4901 Veterans Memorial Hwy. Metairie LA 70006 78 79 1 >=18 1 2 2 30005996 90192897THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mitchell Jonathan 5008 W. Esplanade Metairie LA 70006 35 65 1 none 1 2 2 30016779 90198963THE PHYSICIAN'S ALLIANCE CORP (TPAC) Varuso Susan 5008 W. Esplanade Metairie LA 70006 37 74 1 none 1 2 2 30016779 90198963HEART CLINIC OF LOUISIANA Cospolich Brian MD 7178 W. Judge Perez Dr. Arabi LA 70032 20 06 1 >=18 1 2 1 29960810 89999099HEART CLINIC OF LOUISIANA Glade Louis B. MD 7178 W. Judge Perez Dr. Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA Kerut Edmund K. MD 7178 W. Judge Perez Dr. Arabi LA 70032 20 06 1 >=18 1 2 1 29960810 89999099HEART CLINIC OF LOUISIANA Kushner Frederick G. MD 7178 W. Judge Perez Dr. Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA LaGuardia Stephen P. MD 7178 W. Judge Perez Dr. Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA Levenson Leslie W. MD 7178 W. Judge Perez Dr. Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA Matheney Robert D. MD 7178 W. Judge Perez Dr. Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA Stein Maureen W. MD 7178 W. Judge Perez Dr. Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Cospolich Brian J. MD 7178 W. Judge Perez Drive Arabi LA 70032 20 06 1 >=18 1 2 1 29960810 89999099HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Glade Louis B. MD 7178 W. Judge Perez Drive Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Kerut Edmund K. MD 7178 W. Judge Perez Drive Arabi LA 70032 20 06 1 >=18 1 2 1 29960810 89999099HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Kushner Frederick G. MD 7178 W. Judge Perez Drive Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES LaGuardia Stephen P. MD 7178 W. Judge Perez Drive Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Levenson Leslie W. MD 7178 W. Judge Perez Drive Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Matheney Robert D. MD 7178 W. Judge Perez Drive Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Stein Maureen W. MD 7178 W. Judge Perez Drive Arabi LA 70032 20 06 1 >=18 1 2 2 29960810 89999099MOTION DYNAMICS LLC Bombardier Linda PT 7701 W. Saint Bernard Hwy Arabi LA 70032 35 65 1 none 1 2 2 29952915 89995600ST CHARLES COMMUNITY HEALTH CENTER Ganard Gary FNP 7718 W Judge Perez Drive Arabi LA 70032 78 08 1 None 1 2 2 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Hadi Mohammed MD 7718 W Judge Perez Drive Arabi LA 70032 20 08 1 None 1 2 2 29957793 89990458


LOI Contract STP*

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Age Restricti

onPCP Link

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ST CHARLES COMMUNITY HEALTH CENTER Huarcaya Erick MD 7718 W Judge Perez Drive Arabi LA 70032 20 08 1 None 1 2 1 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Joseph Kevin O. MD 7718 W Judge Perez Drive Arabi LA 70032 20 08 1 None 1 2 1 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Lefant John FNP 7718 W Judge Perez Drive Arabi LA 70032 78 08 1 None 1 2 2 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Mardia Sudha MD 7718 W Judge Perez Drive Arabi LA 70032 20 08 1 None 1 2 1 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Nachabe Moustafa MD 7718 W Judge Perez Drive Arabi LA 70032 20 37 1 <=18 1 2 1 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Spence Elizabeth NP 7718 W Judge Perez Drive Arabi LA 70032 78 79 1 >=18 1 2 2 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Thien John MD 7718 W Judge Perez Drive Arabi LA 70032 20 08 1 >=18 1 2 1 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Truxillo Ryan MD 7718 W Judge Perez Drive Arabi LA 70032 20 08 1 None 1 2 1 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Verrette Paul MD 7718 W Judge Perez Drive Arabi LA 70032 20 08 1 >=18 1 2 2 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER 7718 W Judge Perez Drive Aribi LA 70032 72 9L 1 none 1 2 1 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Bertucci Bryan MD 7718 W Judge Perez Drive Aribi LA 70032 20 08 1 None 1 2 1 29957793 89990458ST CHARLES COMMUNITY HEALTH CENTER Sadeghpour Bahram MD 7718 W Judge Perez Drive Aribi LA 70032 20 37 1 <=18 1 2 1 29957793 89990458US MED CARE, LLC 7682 Highway 23 Belle Chasse LA 70037 20 41 1 >=18 1 2 2 29865861 90001048US MED CARE, LLC Chakraborti Jyoti 7682 Hwy. 23 Belle Chasse LA 70037 20 41 1 >=18 1 2 2 29865861 90001048US MED CARE, LLC Holmes William 7682 Hwy. 23 Belle Chasse LA 70037 20 08 1 None 1 2 2 29865861 90001048US MED CARE, LLC Okonkwo Ndubueze Fidelis 7682 Hwy. 23 Belle Chasse LA 70037 20 41 1 >=18 1 2 1 29865861 90001048Ochsner Clinic Fontenot Amanda G. 7772 Highway 23 Belle Chasse LA 70037 20 41 1 >=18 1 2 2 29864440 89999148Ochsner Clinic Rodgers Shari J. 7772 Highway 23 Belle Chasse LA 70037 20 08 1 None 1 2 2 29864440 89999148BELLE CHASSE FAMILY MEDICAL Giambelluca Lawrence 8200 Hwy 23 Belle Chasse LA 70037 20 08 1 >=18 1 2 2 29857793 89987778ST CHARLES VISION BOUTTE LLC Leach Timothy J. OD 13322 Hwy 90 Ste L Boutte LA 70039 28 88 1 none 1 2 2 29902981 90382609AUDIBEL HEARING HEALTHCARE 215 W Judge Perez Chalmette LA 70043 34 64 1 none 1 2 2 29943300 89964851LA HEART CENTER Arena Frank MD 2611 Jackson Blvd. Chalmette LA 70043 20 06 1 none 1 2 2 29945684 89970551LA HEART CENTER Bernstein Marc MD 2611 Jackson Blvd. Chalmette LA 70043 20 06 1 none 1 2 2 29945684 89970551LA HEART CENTER Hickey Keith MD 2611 Jackson Blvd. Chalmette LA 70043 20 06 1 none 1 2 2 29945684 89970551LA HEART CENTER Iteld Bruce MD 2611 Jackson Blvd. Chalmette LA 70043 20 06 1 none 1 2 1 29945684 89970551LA HEART CENTER Sharma Sushant MD 2611 Jackson Blvd. Chalmette LA 70043 20 06 1 none 1 2 2 29945684 89970551LA HEART CENTER Silverstein Jay MD 2611 Jackson Blvd. Chalmette LA 70043 20 06 1 none 1 2 2 29945684 89970551LA HEART CENTER Stein Jeffrey NP 2611 Jackson Blvd. Chalmette LA 70043 78 79 1 >=18 1 2 2 29945684 89970551THE MEDICAL DEPOT LLC 3016 Jean Lafitte Pkwy. Ste B Chalmette LA 70043 40 54 1 none 1 2 2 29953805 89980806CHILDREN'S INTERNATIONAL Claycomb Stephen MD 705 E. Judge Perez Drive Chalmette LA 70043 20 37 1 <=18 1 2 1 29940643 89957660CHILDREN'S INTERNATIONAL Cohen Irwin MD 705 E. Judge Perez Drive Chalmette LA 70043 20 37 1 <=18 1 2 1 29940643 89957660CHILDREN'S INTERNATIONAL Hernandez Eduardo MD 705 E. Judge Perez Drive Chalmette LA 70043 20 29 1 none 1 2 1 29940643 89957660CHILDREN'S INTERNATIONAL Jeansonne Cornel MD 705 E. Judge Perez Drive Chalmette LA 70043 20 37 1 <=18 1 2 1 29940643 89957660CHILDREN'S INTERNATIONAL Moody Kristi NP 705 E. Judge Perez Drive Chalmette LA 70043 78 08 1 >=18 1 2 1 29940643 89957660CHILDREN'S INTERNATIONAL Narumanchi Janani MD 705 E. Judge Perez Drive Chalmette LA 70043 20 37 1 <=18 1 2 1 29940643 89957660CHILDREN'S INTERNATIONAL Plauche Andrea NP 705 E. Judge Perez Drive Chalmette LA 70043 78 79 1 >=18 1 2 2 29940643 89957660CHILDREN'S INTERNATIONAL Pouw I.S. Victor MD 705 E. Judge Perez Drive Chalmette LA 70043 20 2E 1 none 1 2 1 29940643 89957660CHILDREN'S INTERNATIONAL Wilson Ella NP 705 E. Judge Perez Drive Chalmette LA 70043 78 08 1 >=18 1 2 1 29940643 89957660FAMILY HEALTH CARE CLINIC of St. Bernard, LLC Labarre Tammi C. FNP 8301 W. Judge Perez Dr. Ste. 207 Chalmette LA 70043 78 08 1 none 1 2 2 29956651 89986337FAMILY HEALTH CARE CLINIC of St. Bernard, LLC Licciardi Paula FNP 8301 W. Judge Perez Dr. Ste. 207 Chalmette LA 70043 78 08 1 none 1 2 2 29956651 89986337THE EYE CENTER Schoenberger Martin J. MD 901 W. Judge Perez Dr Chalmette LA 70043 20 18 1 none 1 2 1 29945080 89969691LOUISIANA DISCOUNT OPTICAL 9128 W. Judge Perez Drive Chalmette LA 70043 40 54 1 none 1 2 2 29950584 89973075MULLER DENNIS J OD Muller Dennis J. OD 9128 West Judge Perez Drive Chalmette LA 70043 28 88 1 none 1 2 2 29950584 89973075Ochsner Clinic Calix Danielle M. 1970 Ormond Blvd. Destrehan LA 70047 20 37 1 <=18 1 2 2 29970073 90367462Ochsner Clinic DePaula Alicia C. 1970 Ormond Blvd. Destrehan LA 70047 20 37 1 <=18 1 2 2 29970073 90367462Ochsner Clinic Glick Amy PT 1970 Ormond Blvd. Suite J Destrehan LA 70047 20 37 1 <=18 1 2 2 29970073 90367462Ochsner Clinic Granier Patricia M. PT 1970 Ormond Blvd. Destrehan LA 70047 20 37 1 <=18 1 2 2 29970073 90367462Ochsner Clinic Seoane L. Michelle 1970 Ormond Blvd. Destrehan LA 70047 20 37 1 <=18 1 2 2 29970073 90367462Ochsner Clinic Wasserman Michael F. PT 1970 Ormond Blvd. Destrehan LA 70047 20 37 1 <=18 1 2 2 29970073 90367462DOROTHY K ANDERSON OD Anderson Dorothy K. OD 1972 Ormond Blvd Destrehan LA 70047 28 88 1 none 1 2 2 29970088 90367439


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

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DOROTHY K ANDERSON OD Beam Amy C. OD 1972 Ormond Blvd Destrehan LA 70047 28 88 1 none 1 2 2 29970088 90367439THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cronin Christopher 1972 Ormond Blvd. D Destrehan LA 70047 35 65 1 none 1 2 2 29970088 90367439THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dufrene Jeanie 1972 Ormond Blvd. D Destrehan LA 70047 35 65 1 none 1 2 2 29970088 90367439THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kirchem Charles 1972 Ormond Blvd. D Destrehan LA 70047 35 65 1 none 1 2 2 29970088 90367439THE PHYSICIAN'S ALLIANCE CORP (TPAC) Soulie Bryan 1972 Ormond Blvd. D Destrehan LA 70047 35 65 1 none 1 2 2 29970088 90367439ST CHARLES COMMUNITY HEALTH CENTER 105 Plantation Road Drestrehan LA 70047 72 9L 1 none 1 2 1 29970972 90376934ST CHARLES COMMUNITY HEALTH CENTER Hadi Mohammed MD 105 Plantation Road Drestrehan LA 70047 20 08 1 None 1 2 2 29970972 90376934ST CHARLES COMMUNITY HEALTH CENTER Huarcaya Erick MD 105 Plantation Road Drestrehan LA 70047 20 08 1 None 1 2 1 29970972 90376934ST CHARLES COMMUNITY HEALTH CENTER Jayakrishman Chemmal MD 105 Plantation Road Drestrehan LA 70047 20 06 1 none 1 2 2 29970972 90376934ST CHARLES COMMUNITY HEALTH CENTER Joseph Kevin O. MD 105 Plantation Road Drestrehan LA 70047 20 08 1 None 1 2 1 29970972 90376934ST CHARLES COMMUNITY HEALTH CENTER Mardia Sudha MD 105 Plantation Road Drestrehan LA 70047 20 08 1 None 1 2 1 29970972 90376934ST CHARLES COMMUNITY HEALTH CENTER Nachabe Moustafa MD 105 Plantation Road Drestrehan LA 70047 20 37 1 <=18 1 2 1 29970972 90376934ST CHARLES COMMUNITY HEALTH CENTER Sadeghpour Bahram MD 105 Plantation Road Drestrehan LA 70047 20 37 1 <=18 1 2 1 29970972 90376934ST CHARLES COMMUNITY HEALTH CENTER Vadakkipalayam Deverajan MD 105 Plantation Road Drestrehan LA 70047 20 2K 1 none 1 2 2 29970972 90376934TECHE ACTION CLINIC 149 East Third Street Edgard LA 70049 72 9L 1 none 1 2 1 30044159 90559790TECHE ACTION CLINIC Brignac Jeanenne C. 149 East Third Street Edgard LA 70049 20 08 1 None 1 2 1 30044159 90559790TECHE ACTION CLINIC Bustillo Mayra S. 149 East Third Street Edgard LA 70049 20 37 1 <=18 1 2 2 30044159 90559790TECHE ACTION CLINIC Clay Lori W. 149 East Third Street Edgard LA 70049 78 08 1 None 1 2 1 30044159 90559790TECHE ACTION CLINIC Clay Melissa W. 149 East Third Street Edgard LA 70049 78 08 1 None 1 2 2 30044159 90559790TECHE ACTION CLINIC Delgado Guillermo E. CRNA 149 East Third Street Edgard LA 70049 20 16 1 >=16 1 2 2 30044159 90559790TECHE ACTION CLINIC Eure Elizabeth C. 149 East Third Street Edgard LA 70049 78 08 1 None 1 2 2 30044159 90559790TECHE ACTION CLINIC Fabre Jennifer C. 149 East Third Street Edgard LA 70049 78 08 1 >=18 1 2 2 30044159 90559790TECHE ACTION CLINIC Gautam Chatshu 149 East Third Street Edgard LA 70049 20 08 1 None 1 2 1 30044159 90559790TECHE ACTION CLINIC Gisclair Heather R. 149 East Third Street Edgard LA 70049 78 08 1 None 1 2 2 30044159 90559790TECHE ACTION CLINIC Hinds Trenton A. 149 East Third Street Edgard LA 70049 20 41 1 >=18 1 2 2 30044159 90559790TECHE ACTION CLINIC Miller Candice M. 149 East Third Street Edgard LA 70049 78 08 1 >=18 1 2 1 30044159 90559790TECHE ACTION CLINIC Millet Jennifer R. 149 East Third Street Edgard LA 70049 78 08 1 None 1 2 2 30044159 90559790TECHE ACTION CLINIC Molinere Stacey B. 149 East Third Street Edgard LA 70049 78 08 1 None 1 2 2 30044159 90559790TECHE ACTION CLINIC Morgan Cara M. 149 East Third Street Edgard LA 70049 20 08 1 None 1 2 1 30044159 90559790TECHE ACTION CLINIC Wiltz Gary M. 149 East Third Street Edgard LA 70049 20 41 1 >=18 1 2 2 30044159 90559790ST. JAMES PRIMARY CARE Fangue Catherine 827 N. Pine St Gramercy LA 70052 78 08 1 none 1 2 2 30060339 90700564ST. JAMES PRIMARY CARE Roussel Toni 827 N. Pine St Gramercy LA 70052 78 08 1 none 1 2 2 30060339 90700564ST. JAMES PRIMARY CARE Thatikonda Narender 827 N. Pine St Gramercy LA 70052 20 41 1 <=18 1 2 1 30060339 90700564ST. JAMES PRIMARY CARE Vellanki Anu P. 827 N. Pine St Gramercy LA 70052 20 41 1 none 1 2 1 30060339 90700564ST. JAMES PRIMARY CARE 827 N. Pine Street Gramercy LA 70052 79 94 1 none 1 2 1 30060339 90700564GRETNA MEDICAL CLINIC Nguyen Hai Nam 1221 Amelia Street Gretna LA 70053 20 41 1 >=18 1 2 1 29911580 90055617A-MED AMBULANCE INC 1800 Monroe St. Gretna LA 70053 51 59 1 none 1 2 1 29920795 90050478BONE & JOINT CLINIC OF NEW ORLEANS Shackelton Robert L. MD 2600 Belle Chasse Hwy Gretna LA 70053 20 20 1 none 1 2 2 29900708 90047568NEWCO WOMENS MEDICAL CENTER Allen Mark M. MD 515 West Bank Expressway Gretna LA 70053 20 16 1 none 1 2 2 29910061 90057034NEWCO WOMENS MEDICAL CENTER Bigelow Jennifer L. MD 515 West Bank Expressway Gretna LA 70053 20 16 1 none 1 2 2 29910061 90057034NEWCO WOMENS MEDICAL CENTER Blanton Elizabeth 515 West Bank Expressway Gretna LA 70053 20 16 1 none 1 2 1 29910061 90057034NEWCO WOMENS MEDICAL CENTER Castillo Sergio F. MD 515 West Bank Expressway Gretna LA 70053 20 16 1 none 1 2 1 29910061 90057034NEWCO WOMENS MEDICAL CENTER Clasen Stacey B. MD 515 West Bank Expressway Gretna LA 70053 20 16 1 none 1 2 1 29910061 90057034NEWCO WOMENS MEDICAL CENTER Hutchinson Jeanne 515 West Bank Expressway Gretna LA 70053 20 16 1 none 1 2 1 29910061 90057034NEWCO WOMENS MEDICAL CENTER Rosenberg Henry L. MD 515 West Bank Expressway Gretna LA 70053 20 16 1 none 1 2 1 29910061 90057034NEWCO WOMENS MEDICAL CENTER Sirven Carlos A. MD 515 West Bank Expressway Gretna LA 70053 20 16 1 none 1 2 1 29910061 90057034THE PHYSICIAN'S ALLIANCE CORP (TPAC) Blanton Elizabeth 515 Westbank Expwy, Suite 7 Gretna LA 70053 20 16 1 >=16 1 2 1 29910061 90057034THE PHYSICIAN'S ALLIANCE CORP (TPAC) Castillo Sergio 515 Westbank Expwy, Suite 7 Gretna LA 70053 20 16 1 >=16 1 2 1 29910061 90057034THE PHYSICIAN'S ALLIANCE CORP (TPAC) Clasen Stacey 515 Westbank Expwy, Suite 7 Gretna LA 70053 20 16 1 >=16 1 2 1 29910061 90057034THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cohen R. Catherine 515 Westbank Expwy, Suite 7 Gretna LA 70053 20 16 1 >=16 1 2 2 29910061 90057034


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hutchinson Jeanne 515 Westbank Expwy, Suite 7 Gretna LA 70053 20 16 1 >=16 1 2 1 29910061 90057034THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lupin Ellis 515 Westbank Expwy, Suite 7 Gretna LA 70053 20 16 1 >=16 1 2 1 29910061 90057034THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rosenberg Henry 515 Westbank Expwy, Suite 7 Gretna LA 70053 20 16 1 >=16 1 2 1 29910061 90057034LABCORP 515 WESTBANK EXPY STE 4 GRETNA LA 70053 20 30 1 none 1 1 2 29910061 90057034HOME MEDICAL RESOURCES INC 59 Fifth Street Gretna LA 70053 40 54 1 none 1 2 1 29920090 90055632BLOOM M ERROL OD / BLOOM OPTOMETRY CLINIC PC Errol Bloom M. OD 80 West Bank Express Gretna LA 70053 28 88 1 none 1 2 2 29912368 90051125LABCORP 120 MEADOWCREST ST GRETNA LA 70056 20 30 1 none 1 1 2 29881876 90026860DIMITRI DERMATOLOGY Birkhoff Janice ANP 120 Meadowcrest St Ste 235 Gretna LA 70056 78 79 1 >=18 1 2 2 29881876 90026860DIMITRI DERMATOLOGY DiMarco Marilyn ANP 120 Meadowcrest St Ste 235 Gretna LA 70056 78 79 1 none 1 2 2 29881876 90026860DIMITRI DERMATOLOGY Dimitri Elizabeth DO 120 Meadowcrest St Ste 235 Gretna LA 70056 19 07 1 none 1 2 1 29881876 90026860DIMITRI DERMATOLOGY Janeski Belinda 120 Meadowcrest St Ste 235 Gretna LA 70056 78 79 1 none 1 2 2 29881876 90026860DIMITRI DERMATOLOGY McDonald Kate MD 120 Meadowcrest St Ste 235 Gretna LA 70056 20 07 1 none 1 2 1 29881876 90026860THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mohnot Dhanpat 120 Meadowcrest St Ste 420 Gretna LA 70056 20 13 1 none 1 2 2 29881876 90026860DIMITRI DERMATOLOGY Mosadegh Mehdi MD 120 Meadowcrest St Ste 235 Gretna LA 70056 20 07 1 none 1 2 1 29881876 90026860MICHAEL HAYDEL MD AMC Haydel Michael P. 120 Meadowcrest St #100 Gretna LA 70056 20 37 1 <=18 1 2 1 29881876 90026860JEFFREY SINGER MD Singer Jeffrey H. MD 120 Meadowcrest St, Suite 330 Gretna LA 70056 20 18 1 none 1 2 2 29881876 90026860HEATH BETTENCOURTT Bettencourtt Heath MD 120 Meadowcrest St. Ste. 470 Gretna LA 70056 20 37 1 <=18 1 2 2 29881876 90026860

Ochsner Clinic Bazan Herman A. 120 Meadowcrest St. Gretna LA 70056 20 2P 1 none 1 2 1 29881876 90026860Ochsner Clinic Clementine Rochelle R. 120 Meadowcrest St. Gretna LA 70056 20 2M 1 none 1 2 2 29881876 90026860

Ochsner Clinic Cook Michael W. 120 Meadowcrest St. Gretna LA 70056 20 02 1 none 1 2 2 29881876 90026860Ochsner Clinic Frank Robert A. 120 Meadowcrest St. Suite 380 Gretna LA 70056 20 33 1 none 1 2 2 29881876 90026860Ochsner Clinic Hamilton Monique P. 120 Meadowcrest St. Suite 220 Gretna LA 70056 20 16 1 >=16 1 2 1 29881876 90026860

Ochsner Clinic Parks Joshua D. 120 Meadowcrest St. Gretna LA 70056 20 02 1 none 1 2 2 29881876 90026860Ochsner Clinic Roberie Margaret A. 120 Meadowcrest St. Suite 220 Gretna LA 70056 20 16 1 >=16 1 2 1 29881876 90026860Ochsner Clinic Robichaux, III Alfred G. 120 Meadowcrest St. Suite 220 Gretna LA 70056 20 16 1 >=16 1 2 1 29881876 90026860Ochsner Clinic Sargent William T. 120 Meadowcrest St. Suite 220 Gretna LA 70056 20 16 1 >=16 1 2 1 29881876 90026860Ochsner Clinic Vuong Vu A. 120 Meadowcrest St. Suite 460 Gretna LA 70056 20 16 1 >=16 1 2 1 29881876 90026860MICHAEL HAYDEL MD AMC Fantaci Lindsay York 120 Meadowcrest St. #100 Gretna LA 70056 20 37 1 <=18 1 2 1 29881876 90026860MICHAEL HAYDEL MD AMC Capone Kenneth J. 120 Meadowcrest St., #100 Gretna LA 70056 20 37 1 <=18 1 2 1 29881876 90026860WESTSIDE DERMATOLOGY ASSOCIATES, AMPC Klinger Stephen J. MD 120 Meadowcrest St., #160 Gretna LA 70056 20 07 1 none 1 2 2 29881876 90026860WESTSIDE DERMATOLOGY ASSOCIATES, AMPC Marshall, Jr. Daniel A. MD 120 Meadowcrest St., #160 Gretna LA 70056 20 07 1 none 1 2 2 29881876 90026860WESTSIDE DERMATOLOGY ASSOCIATES, AMPC Russo Glen G. MD 120 Meadowcrest St., #160 Gretna LA 70056 20 07 1 none 1 2 2 29881876 90026860WESTSIDE DERMATOLOGY ASSOCIATES, AMPC Russo Gordon J. MD 120 Meadowcrest St., #160 Gretna LA 70056 20 07 1 none 1 2 2 29881876 90026860BRYAN WASHINGTON MD Bryan, Sr. Washington M.D. 120 Meadowcrest St., #230 Gretna LA 70056 20 16 1 none 1 2 1 29881876 90026860HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Cospolich Brian J. MD 120 Meadowcrest St., #410 Gretna LA 70056 20 06 1 >=18 1 2 1 29881876 90026860HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Glade Louis B. MD 120 Meadowcrest St., #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Kerut Edmund K. MD 120 Meadowcrest St., #410 Gretna LA 70056 20 06 1 >=18 1 2 1 29881876 90026860HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Kushner Frederick G. MD 120 Meadowcrest St., #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES LaGuardia Stephen P. MD 120 Meadowcrest St., #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Levenson Leslie W. MD 120 Meadowcrest St., #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Matheney Robert D. MD 120 Meadowcrest St., #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Stein Maureen W. MD 120 Meadowcrest St., #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860BOOS THOMAS A MD Kappelman Mark D. 120 Meadowcrest St., #450 Gretna LA 70056 20 02 1 none 1 2 2 29881876 90026860BOOS THOMAS A MD Minnard Emery A. 120 Meadowcrest St., #450 Gretna LA 70056 20 02 1 none 1 2 2 29881876 90026860BOOS THOMAS A MD Sherafgan Kashaf 120 Meadowcrest St., #450 Gretna LA 70056 20 02 1 none 1 2 2 29881876 90026860JEFFREY SINGER MD D'Antonio M. Christine MD 120 Meadowcrest Street Suite 330 Gretna LA 70056 20 18 1 none 1 2 2 29881876 90026860JEFFREY SINGER MD Gillen Sharon MD 120 Meadowcrest Street Suite 330 Gretna LA 70056 20 18 1 none 1 2 2 29881876 90026860

Gretna MOB Suite 320




LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Scanlan Marideli 120 Meadowcrest Street #340 Gretna LA 70056 20 2E 1 none 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA Cospolich Brian MD 120 Meadowcrest Street, #410 Gretna LA 70056 20 06 1 >=18 1 2 1 29881876 90026860HEART CLINIC OF LOUISIANA Glade Louis B. MD 120 Meadowcrest Street, #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA Kerut Edmund K. MD 120 Meadowcrest Street, #410 Gretna LA 70056 20 06 1 >=18 1 2 1 29881876 90026860HEART CLINIC OF LOUISIANA Kushner Frederick G. MD 120 Meadowcrest Street, #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA LaGuardia Stephen P. MD 120 Meadowcrest Street, #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA Levenson Leslie W. MD 120 Meadowcrest Street, #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA Matheney Robert D. MD 120 Meadowcrest Street, #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860HEART CLINIC OF LOUISIANA Stein Maureen W. MD 120 Meadowcrest Street, #410 Gretna LA 70056 20 06 1 >=18 1 2 2 29881876 90026860JEFFREY SINGER MD Brint Stephen F. MD, FACS 120 Meadowcrest Street, Suite 330 Gretna LA 70056 20 18 1 none 1 2 2 29881876 90026860Ochsner Clinic Vuppala Amanda M. 123 Meadowcrest Blvd. Suite 310 Gretna LA 70056 20 2H 1 none 1 2 2 29884221 90026079MOON ORTHOPEDICS 139 Bellemeade Blvd Gretna LA 70056 40 53 1 none 1 2 2 29891652 90036832WESTBANK URGENT CARE Mehaffie Douglas MD 148 Wall Blvd Gretna LA 70056 20 08 1 none 1 2 2 29886700 90031481THOMAS R. SMITH, M.D. Smith Thomas Richard MD 151 Meadowcrest St. Suite H Gretna LA 70056 20 16 1 >=16 1 2 1 29883547 90026121THE PHYSICIAN'S ALLIANCE CORP (TPAC) Caillet Jaime 1712 Stumpf Blvd. Gretna LA 70056 35 65 1 none 1 2 2 29911646 90040554THE PHYSICIAN'S ALLIANCE CORP (TPAC) Clement Chesson 1712 Stumpf Blvd. Gretna LA 70056 35 65 1 none 1 2 2 29911646 90040554THE PHYSICIAN'S ALLIANCE CORP (TPAC) Delahoussaye Scott 1712 Stumpf Blvd. Gretna LA 70056 35 65 1 none 1 2 2 29911646 90040554THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dennenmueller Amber 1712 Stumpf Blvd. Gretna LA 70056 35 65 1 none 1 2 2 29911646 90040554THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson Johnny 1712 Stumpf Blvd. Gretna LA 70056 35 65 1 none 1 2 2 29911646 90040554THE PHYSICIAN'S ALLIANCE CORP (TPAC) Squatrito Joseph 1712 Stumpf Blvd. Gretna LA 70056 35 65 1 none 1 2 2 29911646 90040554THE PHYSICIAN'S ALLIANCE CORP (TPAC) St Romain Gwendolyn 1712 Stumpf Blvd. Gretna LA 70056 35 65 1 none 1 2 2 29911646 90040554THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daniels Bertha 175 Hector Ave Gretna LA 70056 20 41 1 >=18 1 2 2 29918017 90040769THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lucio Daniel 175 Hector Ave Gretna LA 70056 20 41 1 >=18 1 2 2 29918017 90040769THE PHYSICIAN'S ALLIANCE CORP (TPAC) Plummer Cassandra 175 Hector Ave Gretna LA 70056 20 08 1 None 1 2 2 29918017 90040769THE PHYSICIAN'S ALLIANCE CORP (TPAC) Richards Christopher L. 175 Hector Ave Gretna LA 70056 20 41 1 >=18 1 2 2 29918017 90040769THE PHYSICIAN'S ALLIANCE CORP (TPAC) Williams Jennifer 175 Hector Ave Gretna LA 70056 20 08 1 None 1 2 2 29918017 90040769BONE & JOINT CLINIC OF NEW ORLEANS Gallager Daniel J. MD 2066 Belle Chasse Hwy Gretna LA 70056 20 20 1 none 1 2 2 29890409 90033775ALIX BOUCHETTE MD Bouchette Alix MD 230 Meadowcrest St. Gretna LA 70056 20 08 1 None 1 2 1 29882071 90026670Ochsner Foundation Hospital 2500 Belle Chase Hwy Gretna LA 70056 60 86 1 none 1 2 2 29885494 90027232Ochsner Clinic Akhondzadeh Abdolazim 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Arapos Leonidas 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Battula Sarath B. 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Belleville Francine 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 2 29885494 90027232Ochsner Clinic Broussard Erica M. 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 2 29885494 90027232Ochsner Clinic Brown, Jr. John F. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 1 29885494 90027232Ochsner Clinic Casey Stephanie D. 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 1 29885494 90027232Ochsner Clinic Cockerham Karen R. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 2 29885494 90027232Ochsner Clinic Cresswell, III Lawrence H. 2500 Belle Chasse Highway Gretna LA 70056 19 1T 1 none 1 2 2 29885494 90027232Ochsner Clinic Dennis Patrick M. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 2 29885494 90027232Ochsner Clinic DeRosales Ana Belen R. 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Dowling Adam M. 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 2 29885494 90027232Ochsner Clinic Emerson Noah A. 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 1 29885494 90027232Ochsner Clinic Gonzalez Manuel E. 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Gupta Shaminder M. 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 1 29885494 90027232Ochsner Clinic Harlan Daniel C. PT 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 1 29885494 90027232Ochsner Clinic Helm Boyd M. 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 2 29885494 90027232Ochsner Clinic Hemelt Don M. 2500 Belle Chasse Highway Gretna LA 70056 20 22 1 none 1 2 2 29885494 90027232Ochsner Clinic Herbert Kristin A. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 1 29885494 90027232Ochsner Clinic Hill Travis W. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 1 29885494 90027232Ochsner Clinic Hue Tessa M. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 2 29885494 90027232


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Hutchings Rebecca A. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 1 29885494 90027232Ochsner Clinic Jancich Sophy A. 2500 Belle Chasse Highway Gretna LA 70056 20 2H 1 none 1 2 2 29885494 90027232Ochsner Clinic Kirsh David S. 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 2 29885494 90027232Ochsner Clinic Kitlas Arleta A. 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Kuo Jeffrey S. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 1 29885494 90027232Ochsner Clinic Langley John M. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 1 29885494 90027232Ochsner Clinic Liokis Evangelos A. 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 2 29885494 90027232Ochsner Clinic Lopez Alberto M. 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Mohan Geetika 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Nath Arup K. 2500 Belle Chasse Highway Gretna LA 70056 19 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Ochello Charles T. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 2 29885494 90027232Ochsner Clinic Oden Tara O. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 2 29885494 90027232Ochsner Clinic Phillips John S. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 2 29885494 90027232Ochsner Clinic Reed Phillip L. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 1 29885494 90027232Ochsner Clinic Rice Mark R. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 2 29885494 90027232Ochsner Clinic Safavi Kurosh A. 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 1 29885494 90027232Ochsner Clinic Skeins Elizabeth C. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 2 29885494 90027232Ochsner Clinic Stephens Charles R. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 1 29885494 90027232Ochsner Clinic Stevens Carrier Ariane M. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 2 29885494 90027232Ochsner Clinic Tamma Srikanth 2500 Belle Chasse Highway Gretna LA 70056 20 2H 1 none 1 2 2 29885494 90027232Ochsner Clinic Ulfers Gretchen 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Vanderbrook Richard C. 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 2 29885494 90027232Ochsner Clinic Varughese Amy G. 2500 Belle Chasse Highway Gretna LA 70056 20 41 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Wakabashi Masako N. PT 2500 Belle Chasse Highway Gretna LA 70056 20 30 1 none 1 2 2 29885494 90027232Ochsner Clinic Waldo Stephen M. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 2 29885494 90027232Ochsner Clinic Wierzbicki Derek A. 2500 Belle Chasse Highway Gretna LA 70056 20 1T 1 none 1 2 1 29885494 90027232Ochsner Clinic Hugener Aimee J. 2500 Belle Chasse Hwy. Gretna LA 70056 78 79 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Killian Eugenie 2500 Belle Chasse Hwy. Gretna LA 70056 78 37 1 <=18 1 2 2 29885494 90027232Ochsner Clinic Moore Pamela T. 2500 Belle Chasse Hwy. Gretna LA 70056 78 79 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Parson Janet K. 2500 Belle Chasse Hwy. Gretna LA 70056 78 79 1 >=18 1 2 2 29885494 90027232Ochsner Clinic Warner-Smith Angela 2500 Belle Chasse Hwy. Gretna LA 70056 78 79 1 >=18 1 2 2 29885494 90027232Quest Diagnostics 2600 Belle Chasse Highway Suite 207 Gretna LA 70056 20 30 1 none 1 1 2 29884697 90026156BONE & JOINT CLINIC OF NEW ORLEANS Boyd Roderick S. 2600 Belle Chasse Hwy Gretna LA 70056 35 65 1 none 1 2 2 29884697 90026156BONE & JOINT CLINIC OF NEW ORLEANS Habetz Scott J. MD 2600 Belle Chasse Hwy Gretna LA 70056 20 20 1 none 1 2 2 29884697 90026156BONE & JOINT CLINIC OF NEW ORLEANS Robert, III Kearny D. MD 2600 Belle Chasse Hwy Gretna LA 70056 20 20 1 none 1 2 2 29884697 90026156BONE & JOINT CLINIC OF NEW ORLEANS Rozas Earl J. MD 2600 Belle Chasse Hwy Gretna LA 70056 20 20 1 none 1 2 2 29884697 90026156BONE & JOINT CLINIC OF NEW ORLEANS Segura Ronald C. MD 2600 Belle Chasse Hwy Gretna LA 70056 20 05 1 none 1 2 2 29884697 90026156BONE & JOINT CLINIC OF NEW ORLEANS Todd, III James M. MD 2600 Belle Chasse Hwy Gretna LA 70056 20 20 1 none 1 2 2 29884697 90026156BONE & JOINT CLINIC OF NEW ORLEANS Vollman Valerie 2600 Belle Chasse Hwy Gretna LA 70056 35 65 1 none 1 2 2 29884697 90026156THE PHYSICIAN'S ALLIANCE CORP (TPAC) Krivitsky Olga 3201 Wall Blvd Gretna LA 70056 35 65 1 none 1 2 2 29865792 90031210Ochsner Clinic Waitt, Jr. Edward J. 441 Wall Blvd. Gretna LA 70056 20 41 1 >=18 1 2 2 29878384 90030360CV EYECARE L L C Songy Brock J. OD 608 Terry Pkwy. Terrytown LA 70056 28 88 1 none 1 2 2 29903442 90030447CV EYECARE L L C Thompson Joseph C. MD 608 Terry Pkwy. Terrytown LA 70056 20 18 1 none 1 2 2 29903442 90030447CV EYECARE L L C Vincent Cary J. OD 608 Terry Pkwy. Terrytown LA 70056 28 88 1 none 1 2 2 29903442 90030447BLAHNIK SCOTT M OD Blahnik Scott M. OD 93 Terry Parkway, Ste. 9 Terrytown LA 70056 28 88 1 none 1 2 2 29921847 90034987FRANZ III ARTHUR J OD Franz Arthur J. MD 1525 Lapalco Blvd #18 Harvey LA 70058 28 88 1 none 1 2 2 29875705 90046409THE PHYSICIAN'S ALLIANCE CORP (TPAC) Goodwin Craig 1530 Lapalco Blvd. Suite 21 Harvey LA 70058 35 65 1 none 1 2 2 29876120 90047259THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nuss Henry 1530 Lapalco Blvd. Suite 21 Harvey LA 70058 35 65 1 none 1 2 2 29876120 90047259KEITH VAN METER & ASSOCIATES APMC Adhikari Pratik MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Aiken James MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

KEITH VAN METER & ASSOCIATES APMC Alcid Carla MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 1 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Alessi Francis MD 1816 Industrial Blvd. Harvey LA 70058 20 33 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Amareneni Kumar MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Anand Parveen MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Ary Roy MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Avegno Jennifer MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Bennett Roderick MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Bergeron Nicole MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Berner, III August J. MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Butts Christine MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Camero Luis 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Campisi Michele MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Castillo Julio MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Chehardy Charles MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Clayton Marcus MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Couk John MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC DeBlieux Peter MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Dedinsky Mark MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Deschutter Mathieu MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 1 29878920 90083755VAN METER MD & ASSOC AMC Detiege Pierre MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Dunbar Lala MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Elder Jeffery MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Fernandez Gregory MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Fisher Erica MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Gentry Peter MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Gray Jon MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 1 29878920 90083755VAN METER MD & ASSOC AMC Green Kirby MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Haile Jennifer MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Halton Edward MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Harch Paul MD 1816 Industrial Blvd. Harvey LA 70058 20 08 1 None 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Hardy Sean MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Hauver Terence MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Haydel Micelle MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Hayman Bernard MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Hebert Corey MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Hubbell Kathleen MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Jones Kathleen MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Joplin Christopher MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Keane Matthew MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 1 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Kirby Linda MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Kolinsky Michael MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Kuo Jeffrey S. MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 1 29878920 90083755VAN METER MD & ASSOC AMC Lagasse Scott MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Le Audrey MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Legros Tracy MD 1816 Industrial Blvd. Harvey LA 70058 20 08 1 None 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Legros Tracy MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Lister W. Mark MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 1 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Longwell Sidney MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Mallernee Steve MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Marney Nicholas MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 1 29878920 90083755


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

VAN METER MD & ASSOC AMC Martinez Jorge MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC McKay Melissa MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Meka Ujwal MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 1 29878920 90083755VAN METER MD & ASSOC AMC Mills Trevor MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Moises James MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Moreno-Walton Lisa MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Muntan Charles 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Murphy-Lavoie Heather MD 1816 Industrial Blvd. Harvey LA 70058 20 08 1 None 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Piazza Vanessa MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Pierce Diane MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Robinson Candace MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Santanilla Jairo MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Saussy Jullette MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Shannon Andrew 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Slaven Ellen MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Slick Julie MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC St. Clair Jeffrey MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Staab Paul MD 1816 Industrial Blvd. Harvey LA 70058 20 08 1 None 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Stafford U. Theo MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 1 29878920 90083755VAN METER MD & ASSOC AMC Stevens Carrier Ariane MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Tatford Brent MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Tuckler Victor MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Van Meter Keith MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Vorhaben Ann 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Wilder Marina MD 1816 Industrial Blvd. Harvey LA 70058 20 37 1 <=18 1 2 2 29878920 90083755VAN METER MD & ASSOC AMC Willoughby Christopher 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Wyatt H. Alan MD 1816 Industrial Blvd. Harvey LA 70058 20 08 1 None 1 2 2 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Zaheri Kamran MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 1 29878920 90083755KEITH VAN METER & ASSOCIATES APMC Zorub Tania MD 1816 Industrial Blvd. Harvey LA 70058 20 1T 1 none 1 2 2 29878920 90083755BUI LINDA LOD Bui Linda L. 1901 Manhattan Blvd, Suite F-107 Harvey LA 70058 28 88 1 none 1 2 2 29886685 90055061JEFFERSON PARISH SBHC - BONNABEL SBHC Jackel Elizabeth 2200 Eighth St Harvey LA 70058 78 79 1 >=18 1 2 2 29904094 90073786JEFFERSON PARISH SBHC - BONNABEL SBHC Wiseman Pamela 2200 Eighth St. Harvey LA 70058 20 37 1 <=18 1 2 2 29904094 90073786THE PHYSICIAN'S ALLIANCE CORP (TPAC) Abuso Candice 2845 Manhattan Blvd Harvey LA 70058 20 41 1 >=18 1 2 2 29870165 90047925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guillen Julio 2845 Manhattan Blvd Harvey LA 70058 20 41 1 >=18 1 2 2 29870165 90047925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moll Christina 2845 Manhattan Blvd Harvey LA 70058 20 41 1 >=18 1 2 2 29870165 90047925THE PHYSICIAN'S ALLIANCE CORP (TPAC) St Martin Kristi 2845 Manhattan Blvd Harvey LA 70058 20 41 1 >=18 1 2 2 29870165 90047925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Newman William 2845 Manhattanblvd Harvey LA 70058 20 41 1 >=18 1 2 2 29899480 90064773BAYOU ORTHOTIC & PROSTHETIC CENTER 3717 Vonnie Dr. Harvey LA 70058 40 53 1 none 1 2 2 29876080 90084422THE PHYSICIAN'S ALLIANCE CORP (TPAC) Imseis Joseph 3909 Lapalco Blvd Suite 100 Harvey LA 70058 20 41 1 >=18 1 2 2 29873717 90088024THE PHYSICIAN'S ALLIANCE CORP (TPAC) Long William 3909 Lapalco Blvd Suite 100 Harvey LA 70058 20 08 1 None 1 2 2 29873717 90088024THE PHYSICIAN'S ALLIANCE CORP (TPAC) Magsino-Bacuta Evelyn 3909 Lapalco Blvd Ste 100 Harvey LA 70058 20 41 1 >=18 1 2 2 29873717 90088024THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morris Sophia 3909 Lapalco Blvd Suite 100 Harvey LA 70058 20 41 1 >=18 1 2 2 29873717 90088024THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nguyen Rebecca 3909 Lapalco Blvd Suite 100 Harvey LA 70058 20 41 1 >=18 1 2 2 29873717 90088024THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rochon Lilibeth 3909 Lapalco Blvd Suite 100 Harvey LA 70058 20 41 1 >=18 1 2 2 29873717 90088024THE PHYSICIAN'S ALLIANCE CORP (TPAC) Waggenspack Jeremy 3909 Lapalco Blvd Suite 100 Harvey LA 70058 20 37 1 <=18 1 2 2 29873717 90088024CAC THANH LE Thanh Le Cac 851 Manhattan Blvd Ste A Harvey LA 70058 20 37 1 <=18 1 2 2 29902721 90065275WARD KATHLEEN J. OD Ward Kathleen J. OD 972 Manhattan Blvd Harvey LA 70058 28 88 1 none 1 2 1 29901053 90064760CLAIBORNE MEDICAL CORPORATION Afzal Fiaz MD 1000 Veterans Blvd Kenner LA 70062 20 41 1 >=18 1 2 1 29978588 90265197DURAMED INC 101524th St Kenner LA 70062 40 54 1 none 1 2 1 30003007 90236808LOUISIANA REHAB PRODUCTS INC 2424 Williams Blvd Ste C Kenner LA 70062 40 53 1 none 1 2 2 30000174 90240873


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

CLAIBORNE MEDICAL CORPORATION Afzal Fiaz MD 2800 Augusta Street Kenner LA 70062 20 41 1 >=18 1 2 1 30005908 90254719PMA MEDICAL TREATMENT Ceasar Shannon MD 613 Williams Blvd Kenner LA 70062 20 08 1 >=18 1 2 2 29977255 90245706THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gautreaux Joseph 613 Williams Blvd Kenner LA 70062 20 08 1 None 1 2 1 29977255 90245706PMA MEDICAL TREATMENT Philips Ricky W. FNP 613 Williams Blvd Kenner LA 70062 78 08 1 >=18 1 2 2 29977255 90245706INNOVATIVE ORTHOTICS & PROSTHETICS 720 Williams Blvd. Kenner LA 70062 40 53 1 none 1 2 2 29978343 90245080Ochsner Medical Center - Kenner 180 W. Esplanade Avenue Kenner LA 70065 60 86 1 none 1 2 1 30023367 90273374Ochsner Clinic Leboeuf Sharon 180 West Esplanade Kenner LA 70065 78 37 1 <=18 1 2 2 30023367 90273374Ochsner Clinic Masson Mary Y. 180 West Esplanade Kenner LA 70065 78 16 1 >=16 1 2 2 30023367 90273374Ochsner Clinic Belleville Francine 180 West Esplanade Ave. Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Broussard Erica M. 180 West Esplanade Ave. Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Cederbom Gunnar 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic DeVun Daniel 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Diethelm Nancy E. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Dowling Adam M. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Eick John J. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Emerson Noah A. 180 West Esplanade Ave. Kenner LA 70065 20 30 1 none 1 2 1 30023367 90273374Ochsner Clinic Hajjar Joseph D. 180 West Esplanade Ave. Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Hew, Jr. Alfred 180 West Esplanade Ave. Kenner LA 70065 20 22 1 none 1 2 2 30023367 90273374Ochsner Clinic Jancich Sophy A. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 2H 1 none 1 2 2 30023367 90273374Ochsner Clinic Kalmar John A. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 1 30023367 90273374Ochsner Clinic Kay Dennis 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Kenney, III Arthur J. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 1 30023367 90273374Ochsner Clinic Kirsh David S. 180 West Esplanade Ave. Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Layman Todd E. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 1 30023367 90273374Ochsner Clinic Liokis Evangelos A. 180 West Esplanade Ave. Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374THE PHYSICIAN'S ALLIANCE CORP (TPAC) Martin David H. 180 West Esplanade Ave. Kenner LA 70065 20 2I 1 none 1 2 2 30023367 90273374THE PHYSICIAN'S ALLIANCE CORP (TPAC) Masri Najy N. 180 West Esplanade Ave. Kenner LA 70065 20 41 1 >=18 1 2 2 30023367 90273374Ochsner Clinic Matthews Charles C. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic McBurney Donald B. 180 West Esplanade Ave. Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Milburn Cristina I. PT 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Milburn James M. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 1 30023367 90273374Ochsner Clinic Muthavarapu Seetha R. 180 West Esplanade Ave. Kenner LA 70065 20 41 1 >=18 1 2 2 30023367 90273374Ochsner Clinic Nachar Oussama 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Restrepo Robert 180 West Esplanade Ave. Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Safavi Kurosh A. 180 West Esplanade Ave. Kenner LA 70065 20 30 1 none 1 2 1 30023367 90273374Ochsner Clinic Smetherman Dana H. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Sossaman Julie G. PT 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Sullivan Michael A. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374Ochsner Clinic Teaford T. Lamar 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 2 30023367 90273374THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thompson Mark A. 180 West Esplanade Ave. Kenner LA 70065 20 41 1 >=18 1 2 2 30023367 90273374Ochsner Clinic Tupler Richard H. 180 West Esplanade Ave. Suite 8087 Kenner LA 70065 20 30 1 none 1 2 1 30023367 90273374THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boudreaux Kristi A. 180 West Esplanade Avenue Kenner LA 70065 20 41 1 >=18 1 2 2 30023367 90273374THE PHYSICIAN'S ALLIANCE CORP (TPAC) Crowe James L. 180 West Esplanade Avenue Kenner LA 70065 20 41 1 >=18 1 2 2 30023367 90273374Luis Franco MD Franco Luis MD 1909 34th St Kenner LA 70065 20 65 1 None 2 1 2 30017757 90241348LUIS R FRANCO MD APMC Franco Luis R. MD 1909 34th Street Kenner LA 70065 35 65 1 none 1 2 2 30017757 90241348THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morse Malika C 200 Esplande Ave Kenner LA 70065 20 2K 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Krause Peter C. 200 W Esplanade Suite 500 Kenner LA 70065 20 20 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ricciardi James E. 200 W Esplanade Suite 500 Kenner LA 70065 20 20 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Marrero Christopher 200 W Esplanade Ave Ste 600 Kenner LA 70065 20 20 1 none 1 2 2 30023315 90272620Quest Diagnostics 200 W Esplanade Ave Suite 309 Kenner LA 70065 20 30 1 none 1 1 2 30023315 90272620


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ST CHARLES COMMUNITY HEALTH CENTER 200 W. Esplanade Ave Suites 305, 310 & 41 Kenner LA 70065 72 9L 1 none 1 2 1 30023315 90272620ROBERT DEBELLEVUE, MD DeBellevue Robert M. MD 200 W. Esplanade Ave Ste 104 Kenner LA 70065 20 07 1 none 1 2 2 30023315 90272620ST CHARLES COMMUNITY HEALTH CENTER Gelman Vadim Richard MD 200 W. Esplanade Ave Suites 305, 310 & 41 Kenner LA 70065 20 16 1 >=16 1 2 1 30023315 90272620ST CHARLES COMMUNITY HEALTH CENTER Hadi Mohammed MD 200 W. Esplanade Ave Suites 305, 310 & 41 Kenner LA 70065 20 08 1 None 1 2 2 30023315 90272620ST CHARLES COMMUNITY HEALTH CENTER Huarcaya Erick MD 200 W. Esplanade Ave Suites 305, 310 & 41 Kenner LA 70065 20 08 1 None 1 2 1 30023315 90272620ST CHARLES COMMUNITY HEALTH CENTER Joseph Kevin O. MD 200 W. Esplanade Ave Suites 305, 310 & 41 Kenner LA 70065 20 08 1 None 1 2 1 30023315 90272620ST CHARLES COMMUNITY HEALTH CENTER Mardia Sudha MD 200 W. Esplanade Ave Suites 305, 310 & 41 Kenner LA 70065 20 08 1 None 1 2 1 30023315 90272620ST CHARLES COMMUNITY HEALTH CENTER Nachabe Moustafa MD 200 W. Esplanade Ave Suites 305, 310 & 41 Kenner LA 70065 20 37 1 <=18 1 2 1 30023315 90272620ST CHARLES COMMUNITY HEALTH CENTER Sadeghpour Bahram MD 200 W. Esplanade Ave Suites 305, 310 & 41 Kenner LA 70065 20 37 1 <=18 1 2 1 30023315 90272620ST CHARLES COMMUNITY HEALTH CENTER Thomas Sophia NP 200 W. Esplanade Ave Suites 305, 310 & 41 Kenner LA 70065 78 79 1 >=18 1 2 1 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campbell James S. 200 W. Esplanade Ave #412 Kenner LA 70065 20 08 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) James, III - Lsu Ernest 200 W. Esplanade Ave #412 Kenner LA 70065 20 08 1 none 1 2 2 30023315 90272620Ochsner Clinic Jens Daniel K. 200 W. Esplanade Ave #412 Kenner LA 70065 20 08 1 None 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Starr Shannon P. 200 W. Esplanade Ave #412 Kenner LA 70065 20 08 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Williams Dave E. 200 W. Esplanade Ave #412 Kenner LA 70065 20 08 1 none 1 2 2 30023315 90272620ANJUMAN ARA Ara Anjuman MD 200 W. Esplanade Ave. Ste. 312 Kenner LA 70065 20 41 1 >=18 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Uribe Luis 200 W. Esplande #103 Kenner LA 70065 20 2K 1 none 1 2 2 30023315 90272620Mohammed Suleman Suleman Mohammed MD 200 W. Esplande Ave #312 Kenner LA 70065 20 08 1 None 1 2 1 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cascio Brett M. 200 West Esplanade Avenue Suite 500 Kenner LA 70065 20 20 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dasa Vinod 200 West Esplanade Avenue #500 Kenner LA 70065 20 20 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Melancon Keith Patrick 200 West Esplanade Avenue Suite 500 Kenner LA 70065 20 20 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rooney Ronald J. 200 West Esplanade Avenue #500 Kenner LA 70065 20 20 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Anthony Lowell B. 200 West Esplanade #200 Kenner LA 70065 20 2H 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boudreaux John P. 200 West Esplanade #200 Kenner LA 70065 20 02 1 none 1 2 2 30023315 90272620BONE & JOINT CLINIC OF NEW ORLEANS Habetz Scott J. MD 200 West Esplanade Suite 500 Kenner LA 70065 20 20 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rolling Jason L. 200 West Esplanade Suite 500 Kenner LA 70065 20 20 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wang Yi-zarn 200 West Esplanade #200 Kenner LA 70065 20 02 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Woltering Eugene A. 200 West Esplanade #200 Kenner LA 70065 20 2H 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Giambrone Nicole 200 West Esplanade Ave Suite 205 Kenner LA 70065 20 37 1 <=18 1 2 2 30023315 90272620Ochsner Clinic Akingbola Aderonke F. 200 West Esplanade Ave. Kenner LA 70065 20 10 1 none 1 2 2 30023315 90272620Ochsner Clinic Cohen Michael B. 200 West Esplanade Ave. MOB-STE. 501 Kenner LA 70065 20 16 1 >=16 1 2 1 30023315 90272620Ochsner Clinic Culotta, Jr. Vincent A. 200 West Esplanade Ave. MOB-STE. 501 Kenner LA 70065 20 16 1 >=16 1 2 1 30023315 90272620Ochsner Clinic Jordan Christine W. 200 West Esplanade Ave. MOB-STE. 501 Kenner LA 70065 20 16 1 >=16 1 2 1 30023315 90272620Ochsner Clinic Laborde Eric L. 200 West Esplanade Ave. Suite 210 Kenner LA 70065 20 34 1 none 1 2 2 30023315 90272620Ochsner Clinic Lanson David O. 200 West Esplanade Ave. Suite 210 Kenner LA 70065 20 08 1 None 1 2 2 30023315 90272620Ochsner Clinic Lindberg Paige E. 200 West Esplanade Ave. Suite 408 Kenner LA 70065 20 04 1 none 1 2 2 30023315 90272620Ochsner Clinic McLaren Robert H. 200 West Esplanade Ave. MOB-STE. 210 Kenner LA 70065 20 34 1 none 1 2 2 30023315 90272620Ochsner Clinic Montgomery Melissa M. 200 West Esplanade Ave. Suite 210 Kenner LA 70065 20 34 1 none 1 2 2 30023315 90272620Ochsner Clinic Puente Dawn M. 200 West Esplanade Ave. MOB-STE. 210 Kenner LA 70065 20 41 1 >=18 1 2 2 30023315 90272620Ochsner Clinic Ramirez Carlos M. 200 West Esplanade Ave. MOB-STE. 210 Kenner LA 70065 20 41 1 >=18 1 2 2 30023315 90272620Ochsner Clinic Rincon Cheryl 200 West Esplanade Ave. MOB-Suite 210 Kenner LA 70065 20 13 1 none 1 2 2 30023315 90272620Ochsner Clinic Robichaux, III Alfred G. 200 West Esplanade Ave. MOB-STE. 501 Kenner LA 70065 20 16 1 >=16 1 2 1 30023315 90272620Ochsner Clinic Sanders Geremy L. 200 West Esplanade Ave. MOB-Suite 210 Kenner LA 70065 20 05 1 none 1 2 2 30023315 90272620Ochsner Clinic Sheth Mehul S. 200 West Esplanade Ave. Kenner LA 70065 20 41 1 >=18 1 2 2 30023315 90272620Ochsner Clinic Tamma Srikanth 200 West Esplanade Ave. Kenner LA 70065 20 2H 1 none 1 2 2 30023315 90272620Ochsner Clinic Tebbe, Jr. James T. 200 West Esplanade Ave. Suite 210 Kenner LA 70065 20 08 1 None 1 2 2 30023315 90272620Ochsner Clinic Truitt Amy E. 200 West Esplanade Ave. Suite 210 Kenner LA 70065 20 16 1 >=16 1 2 1 30023315 90272620Ochsner Clinic Weaver Michael T. 200 West Esplanade Ave. MOB-Suite 210 Kenner LA 70065 20 33 1 none 1 2 2 30023315 90272620Ochsner Clinic Wiedemann Michael A. 200 West Esplanade Ave. Suite 210 Kenner LA 70065 20 16 1 >=16 1 2 1 30023315 90272620Ochsner Clinic Wiedemann, Jr. Alfred G. 200 West Esplanade Ave. MOB-STE. 210 Kenner LA 70065 20 16 1 >=16 1 2 2 30023315 90272620


LOI Contract STP*

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Ochsner Clinic Young Brian J. 200 West Esplanade Ave. Kenner LA 70065 20 37 1 <=18 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ali Juzar 200 West Esplanade Avenue Suite 205 Kenner LA 70065 20 29 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hutchings John J. 200 West Esplanade Avenue Suite 205 Kenner LA 70065 20 10 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kamboj Sanjau 200 West Esplanade Avenue Suite 205 Kenner LA 70065 20 41 1 >=18 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kamboj Sanjay 200 West Esplanade Avenue Suite 205 Kenner LA 70065 20 03 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kumar Prem 200 West Esplanade Avenue Suite 205 Kenner LA 70065 20 03 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) McKay Kelisia B. 200 West Esplanade Avenue Suite 205 Kenner LA 70065 78 08 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Patel Nirupa J 200 West Esplanade Avenue Suite 205 Kenner LA 70065 20 41 1 >=18 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Richards Robert J. 200 West Esplanade Avenue Suite 205 Kenner LA 70065 20 2E 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Yazigi Rashid A. 200 West Esplanade Avenue Suite 205 Kenner LA 70065 20 03 1 none 1 2 2 30023315 90272620

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Joseph Saju 200 West Esplande Ave Kenner LA 70065 20 02 1 none 1 2 2 30023315 90272620Ochsner Clinic Francipane Tammy 2120 Driftwood Blvd. Kenner LA 70065 78 79 1 >=18 1 2 2 30023547 90237139Ochsner Clinic Major Elaine 2120 Driftwood Blvd. Kenner LA 70065 78 79 1 >=18 1 2 2 30023547 90237139Ochsner Clinic Nicks Cheryl 2120 Driftwood Blvd. Kenner LA 70065 78 79 1 >=18 1 2 2 30023547 90237139Ochsner Clinic Schwab Melisa 2120 Driftwood Blvd. Kenner LA 70065 78 79 1 >=18 1 2 2 30023547 90237139Ochsner Clinic Yeager Pamela 2120 Driftwood Blvd. Kenner LA 70065 78 79 1 >=18 1 2 2 30023547 90237139

Ochsner Clinic Asadifar Marzi 2120 Driftwood Boulevard Kenner LA 70065 20 41 1 >=18 1 2 2 30023547 90237139Ochsner Clinic Bernal Jose Alberto 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Bober Robert M. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Breaux Patrick C. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Caldwell Susan P 2120 Driftwood Boulevard Kenner LA 70065 20 41 1 >=18 1 2 2 30023547 90237139Ochsner Clinic Collins Tyrone J. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Cortes-Moran Rafael A. 2120 Driftwood Boulevard Kenner LA 70065 20 08 1 None 1 2 2 30023547 90237139Ochsner Clinic Delaney, Jr. Patrick A. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Dinshaw Homeyar K. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Hider Brandon K. 2120 Driftwood Boulevard Kenner LA 70065 20 08 1 None 1 2 2 30023547 90237139Ochsner Clinic Jenkins James S. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Lessig Paul M. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic McMullan, Jr. Paul W. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Milani Richard V. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Parquet Taura R. 2120 Driftwood Boulevard Kenner LA 70065 20 08 1 None 1 2 2 30023547 90237139Ochsner Clinic Reilly John P. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Rich Gary M. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Shah Sangeeta B. 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139Ochsner Clinic Skelton C. Lynn 2120 Driftwood Boulevard Kenner LA 70065 20 06 1 none 1 2 2 30023547 90237139JEFFERSON PARISH SBHC - BONNABEL SBHC Sheth Mehul 2801 Bruin Dr Kenner LA 70065 20 37 1 <=18 1 2 2 30011624 90229494JEFFERSON PARISH SBHC - BONNABEL SBHC Tigert Nancy 2801 Bruin Dr Kenner LA 70065 78 79 1 >=18 1 2 2 30011624 90229494ROBERTO C. MENDOZA Mendoza Roberto C. MD, APMC 3100 Williams Blvd Kenner LA 70065 78 79 1 >=18 1 2 1 30012987 90239614THE PHYSICIAN'S ALLIANCE CORP (TPAC) Linares Edith L. 321 Florida Avenue Kenner LA 70065 20 37 1 <=18 1 2 2 30034381 90262261RAUL ESTARIS Estaris Raul B. MD 3321 Florida Ave Kenner LA 70065 20 41 1 >=18 1 2 2 30016530 90240867VADIM GELMAN Gelman Vadim R. MD 3555 Loyola Dr. Ste.D Kenner LA 70065 20 16 1 >=16 1 2 1 30024545 90269615DE LA RUA MANUEL O.D. De la Rua Manuel M. OD 3701 Williams Blvd Ste 204 Kenner LA 70065 28 88 1 none 1 2 1 30023569 90239299SYNERGY HOME CARE-SOUTHEASTERN REGION INC 3715 Williams Blvd Ste 102 Kenner LA 70065 44 75 1 none 1 2 2 30023633 90239293DIMITRI DERMATOLOGY Birkhoff Janice ANP 3715 Williams Blvd Ste 100 Kenner LA 70065 78 79 1 >=18 1 2 2 30023633 90239293DIMITRI DERMATOLOGY DiMarco Marilyn ANP 3715 Williams Blvd Ste 100 Kenner LA 70065 78 79 1 none 1 2 2 30023633 90239293DIMITRI DERMATOLOGY Dimitri Elizabeth DO 3715 Williams Blvd Ste 100 Kenner LA 70065 19 07 1 none 1 2 1 30023633 90239293DIMITRI DERMATOLOGY Janeski Belinda 3715 Williams Blvd Ste 100 Kenner LA 70065 78 79 1 none 1 2 2 30023633 90239293DIMITRI DERMATOLOGY McDonald Kate MD 3715 Williams Blvd Ste 100 Kenner LA 70065 20 07 1 none 1 2 1 30023633 90239293DIMITRI DERMATOLOGY Mosadegh Mehdi MD 3715 Williams Blvd Ste 100 Kenner LA 70065 20 07 1 none 1 2 1 30023633 90239293

Lsu Healthcare Network Orthope


LOI Contract STP*

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New Patient

Age Restricti

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THE PHYSICIAN'S ALLIANCE CORP (TPAC) Britsch Gerard 3921 Williams Blvd. Kenner LA 70065 35 65 1 none 1 2 2 30027431 90238958THE PHYSICIAN'S ALLIANCE CORP (TPAC) Goodwin Craig 3921 Williams Blvd. Kenner LA 70065 35 65 1 none 1 2 2 30027431 90238958THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lopez Teddy 3921 Williams Blvd. Kenner LA 70065 35 65 1 none 1 2 2 30027431 90238958HARSHAD M PATEL, MD APMC Patel Harshad M. MD 4216 Florida Ave. Kenner LA 70065 20 41 1 >=18 1 2 2 30033025 90239148VICTORIA SMITH Smith Victoria AM MD 4228 Williams Blvd, Suite 203 Kenner LA 70065 20 08 1 None 1 2 1 30033141 90237965ROMANO FRANK A OD Romano Frank A. OD 4317 Williams Blvd. Kenner LA 70065 28 88 1 none 1 2 1 30034777 90238341QUYNH MAI CLINIC LLC Mai Quynh MD 705 W. Esplanade Ave Ste A Kenner LA 70065 20 08 1 None 1 2 1 30021638 90259020TAKE CARE HEALTH LOUISIANA 821 W. Esplanade Kenner LA 70065 78 08 1 none 1 2 2 30021141 90257029Ochsner Clinic Jones Brandi K. 2120 Driftwood Boulevard Kenner, LA 70065 20 41 1 >=18 1 2 2 30023547 90237139Ochsner Clinic Panepinto Rory P. 2120 Driftwood Boulevard Kenner, LA 70065 32 48 1 none 1 2 2 30023547 90237139THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cefalu Charles A. 200 West Esplanade Avenue Suite 412 New Orleans LA 70065 20 08 1 none 1 2 2 30023315 90272620THE PHYSICIAN'S ALLIANCE CORP (TPAC) Coignet Kenneth 5140 Church St Ste 100 Lafitte LA 70067 20 41 1 >=18 1 2 2 29735100 90127200Quest Diagnostics 501 Rue De Sante Suite 10 La Place LA 70068 20 30 1 none 1 1 2 30074343 90516758ROMANO FRANK A OD Romano Frank A. OD 1036 W. Airline Suite 119 Laplace LA 70068 28 88 1 none 1 2 1 30072949 90497288DALE ROBERT R DC Dale Robert R. DC 1108 W. Airline Hwy LaPlace LA 70068 30 35 1 none 1 2 2 30073159 90498426Dr Wadhwa and Oberoi LLC Wadhwa Manjit K MD 148 Woodland Dr Laplace LA 70068 20 05 1 None 1 2 2 30093898 90470219VADIM GELMAN Gelman Vadim R. MD 2840 Airline Hwy, Ste. D LaPlace LA 70068 20 16 1 >=16 1 2 1 30077815 90526060THE PHYSICIAN'S ALLIANCE CORP (TPAC) Shine Joseph 301 W. Airline Hwy Suite 104 Laplace LA 70068 35 65 1 none 1 2 2 30068415 90483791DIMITRI EYE CARE Dimitri Ronald OD 3025 Hwy 51 LaPlace LA 70068 28 88 1 none 1 2 2 30061641 90475169VISION STORE OF LAPLACE INC 370 Belle Terre Blvd. LaPlace LA 70068 28 88 1 none 1 2 1 30079436 90501840AUDIBEL HEARING HEALTHCARE 429 W Airline Hwy Ste J LaPlace LA 70068 34 64 1 none 1 2 2 30069456 90485851RAINBOW PEDIATRICS De Frank Wendi MD 451 Rue de Sante LaPlace LA 70068 20 37 1 <=18 1 2 2 30073496 90516308RAINBOW PEDIATRICS Foti Karen MD 451 Rue de Sante LaPlace LA 70068 20 37 1 <=18 1 2 1 30073496 90516308RAINBOW PEDIATRICS Jones Nicole MD 451 Rue de Sante LaPlace LA 70068 20 37 1 <=18 1 2 1 30073496 90516308RIVER PARISHES HOSPITAL LLC 500 Rue De Sante LaPlace LA 70068 60 86 1 none 1 2 2 30074441 90516461PEDIATRIC MEDICAL CLINIC Lambert, Jr. Oliver R. MD 501 Rue de Sante Ste 9 LaPlace LA 70068 20 37 1 <=18 1 2 1 30074343 90516758MOTAGHEDI BIJAN MD Motaqhedi Bijan MD 501 Rue de Sante Ste 11 LaPlace LA 70068 20 04 1 none 1 2 1 30074343 90516758LA Heart Center Arena Frank J MD 502 Rue de Sante Laplace LA 70068 20 06 1 >=18 2 1 2 30074475 90516479LA Heart Center Bernstein Marc J MD 502 Rue de Sante Laplace LA 70068 20 06 1 >=18 2 1 2 30074475 90516479ST. JAMES PRIMARY CARE Fangue Catherine 502 Rue De Sante Ste 301 LaPlace LA 70068 78 08 1 none 1 2 2 30074475 90516479LA Heart Center Hickey Keith G MD 502 Rue de Sante Laplace LA 70068 20 06 1 >=18 2 1 2 30074475 90516479LA HEART CENTER Iteld Bruce MD 502 Rue De Sante LaPlace LA 70068 20 06 1 none 1 2 1 30074475 90516479ST. JAMES PRIMARY CARE Roussel Toni 502 Rue De Sante Ste 301 LaPlace LA 70068 78 08 1 none 1 2 2 30074475 90516479Steven A Scalco MD Scalco Steven A MD 502 Rue de Sante Ste 303 LaPlace LA 70068 20 17 1 None 1 2 2 30074475 90516479LA HEART CENTER Sharma Sushant MD 502 Rue de Sante LaPlace LA 70068 20 06 1 none 1 2 2 30074475 90516479LA HEART CENTER Silverstein Jay MD 502 Rue de Sante LaPlace LA 70068 20 06 1 none 1 2 2 30074475 90516479LA HEART CENTER Stein Jeffrey NP 502 Rue de Sante LaPlace LA 70068 78 79 1 >=18 1 2 2 30074475 90516479LA Heart Center Stein Jeffrey J NP 502 Rue de Sante Laplace LA 70068 78 87 1 >=18 2 1 2 30074475 90516479ST. JAMES PRIMARY CARE Thatikonda Narender 502 Rue De Sante Ste 301 LaPlace LA 70068 20 41 1 <=18 1 2 1 30074475 90516479ST. JAMES PRIMARY CARE Vellanki Anu P. 502 Rue De Sante Ste 301 LaPlace LA 70068 20 41 1 none 1 2 1 30074475 90516479ST. JAMES PRIMARY CARE Vellanki Aparna 502 Rue De Sante Ste 301 LaPlace LA 70068 20 41 1 none 1 2 1 30074475 90516479RESPACARE OF LOUISIANA LLC 719 W. 5th St LaPlace LA 70068 40 54 1 >=18 1 2 2 30066582 90506832Premier Medical Rehab Laplace Inc Barrett John MD 900 W Airline Hwy LaPlace LA 70068 20 08 1 None 1 2 2 30072424 90494430Premier Medical Rehab Laplace Inc Cline-Taylor Charlotte APRN 900 W Airline Hwy LaPlace LA 70068 78 08 1 None 2 1 2 30072424 90494430Premier Medical Rehab Laplace Inc Kurpel Jerome MD 900 W Airline Hwy LaPlace LA 70068 20 08 1 None 2 1 2 30072424 90494430PREMIER MEDICAL REHAB - LAPLACE INC. Barrett John DC 900 W. Airline Highway LaPlace LA 70068 30 35 1 none 1 2 2 30072424 90494430David M Ostrick OD Ostrick David M OD 916 Carrollwood Dr Laplace LA 70068 28 88 1 None 2 1 1 30074215 90495997DECK JR ROBERT EMD Deck Robert E. MD 1025 Paul Maillard Rd. Luling LA 70070 20 16 1 >=16 1 2 1 29922903 90372770HAIK & TERRELL LLC Farrell Erin MD 1046 Paul Maillard Rd P.O Box 51 Luling LA 70070 20 18 1 none 1 2 2 29922887 90373159HAIK & TERRELL LLC Finkelstein Elliot OD 1046 Paul Maillard Rd P.O Box 51 Luling LA 70070 28 88 1 none 1 2 2 29922887 90373159


LOI Contract STP*

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New Patient

Age Restricti

onPCP Link

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HAIK & TERRELL LLC Haik Kenneth G. 1046 Paul Maillard Rd P.O Box 51 Luling LA 70070 20 18 1 none 1 2 2 29922887 90373159HAIK & TERRELL LLC Terrell Walter Lee MD 1046 Paul Maillard Rd P.O Box 51 Luling LA 70070 20 18 1 none 1 2 2 29922887 90373159LUIS R FRANCO MD APMC Franco Luis R. MD 1057 Paul Maillard Rd Luling LA 70070 35 65 1 none 1 2 2 29922652 90372958Ochsner Clinic Bernal Jose Alberto 1057 Paul Maillard Rd. Luling LA 70070 20 06 1 none 1 2 2 29922652 90372958Ochsner Clinic Bridsall, Jr. Walter J. 1057 Paul Maillard Rd. Luling LA 70070 20 08 1 None 1 2 2 29922652 90372958Ochsner Clinic Hightower Leslie R. 1057 Paul Maillard Rd. Luling LA 70070 20 13 1 none 1 2 2 29922652 90372958Ochsner Clinic Milani Richard V. 1057 Paul Maillard Rd. Luling LA 70070 20 06 1 none 1 2 2 29922652 90372958Ochsner Clinic Ramee Stephen R. 1057 Paul Maillard Rd. Luling LA 70070 20 06 1 none 1 2 2 29922652 90372958Ochsner Clinic Shah Sangeeta B. 1057 Paul Maillard Rd. Luling LA 70070 20 06 1 none 1 2 2 29922652 90372958Ochsner Clinic Vuppala Amanda M. 1057 Paul Maillard Rd. Luling LA 70070 20 2H 1 none 1 2 2 29922652 90372958Ochsner Clinic Ledet Ann 1057 Paul Mallard Rd. Luling LA 70070 78 79 1 >=18 1 2 2 29922652 90372958LUIS R FRANCO MD APMC Franco Luis R. MD 1125 Paul Maillard Rd Luling LA 70070 35 65 1 none 1 2 2 29921311 90373960BENSON VIAL Benson Monica Vial MD 126 Post Dr. Luling LA 70070 20 08 1 None 1 2 1 29927513 90369063ST CHARLES COMMUNITY HEALTH CENTER 843 Milling Avenue Luling LA 70070 72 9L 1 none 1 2 1 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Comboy Michelle NP 843 Milling Avenue Luling LA 70070 78 08 1 None 1 2 1 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Hadi Mohammed MD 843 Milling Avenue Luling LA 70070 20 08 1 None 1 2 2 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Huarcaya Erick MD 843 Milling Avenue Luling LA 70070 20 08 1 None 1 2 1 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Jayakrishman Chemmal MD 843 Milling Avenue Luling LA 70070 20 06 1 none 1 2 2 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Joseph Kevin O. MD 843 Milling Avenue Luling LA 70070 20 08 1 None 1 2 1 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Lawrence Shona NP 843 Milling Avenue Luling LA 70070 78 08 1 None 1 2 2 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Mardia Sudha MD 843 Milling Avenue Luling LA 70070 20 08 1 None 1 2 1 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Nachabe Moustafa MD 843 Milling Avenue Luling LA 70070 20 37 1 <=18 1 2 1 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Parquet Kawander NP 843 Milling Avenue Luling LA 70070 78 08 1 None 1 2 2 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Sadeghpour Bahram MD 843 Milling Avenue Luling LA 70070 20 37 1 <=18 1 2 1 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Salas Laurie NP 843 Milling Avenue Luling LA 70070 78 08 1 None 1 2 2 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Shukla Neela MD 843 Milling Avenue Luling LA 70070 20 37 1 <=18 1 2 1 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Tabb Yacara MD 843 Milling Avenue Luling LA 70070 20 48 1 none 1 2 1 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER Vadakkipalayam Deverajan MD 843 Milling Avenue Luling LA 70070 20 2K 1 none 1 2 2 29924328 90369175ST CHARLES COMMUNITY HEALTH CENTER 853 Milling Avenue Luling LA 70070 72 9L 1 none 1 2 1 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Comboy Michelle NP 853 Milling Avenue Luling LA 70070 78 08 1 None 1 2 1 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Hadi Mohammed MD 853 Milling Avenue Luling LA 70070 20 08 1 None 1 2 2 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Huarcaya Erick MD 853 Milling Avenue Luling LA 70070 20 08 1 None 1 2 1 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Jayakrishman Chemmal MD 853 Milling Avenue Luling LA 70070 20 06 1 none 1 2 2 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Joseph Kevin O. MD 853 Milling Avenue Luling LA 70070 20 08 1 None 1 2 1 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Lawrence Shona NP 853 Milling Avenue Luling LA 70070 78 08 1 None 1 2 2 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Mardia Sudha MD 853 Milling Avenue Luling LA 70070 20 08 1 None 1 2 1 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Nachabe Moustafa MD 853 Milling Avenue Luling LA 70070 20 37 1 <=18 1 2 1 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Parquet Kawander NP 853 Milling Avenue Luling LA 70070 78 08 1 None 1 2 2 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Sadeghpour Bahram MD 853 Milling Avenue Luling LA 70070 20 37 1 <=18 1 2 1 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Salas Laurie NP 853 Milling Avenue Luling LA 70070 78 08 1 None 1 2 2 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Shukla Neela MD 853 Milling Avenue Luling LA 70070 20 37 1 <=18 1 2 1 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Tabb Yacara MD 853 Milling Avenue Luling LA 70070 20 48 1 none 1 2 1 29924290 90369225ST CHARLES COMMUNITY HEALTH CENTER Vadakkipalayam Deverajan MD 853 Milling Avenue Luling LA 70070 20 2K 1 none 1 2 2 29924290 90369225THE PHYSICIAN'S ALLIANCE CORP (TPAC) Melancon C. 10900 Highway 3125 Ste D Lutcher LA 70071 35 65 1 none 1 2 2 30060400 90704000GRANGER RICHARD LOD Granger Richard L. 10900 Hwy 3125 Ste F Lutcher LA 70071 28 88 1 none 1 2 2 30060400 90704000ST JAMES PARISH HOSPITAL 1645 Lutcher Ave Lutcher LA 70071 60 86 1 none 1 2 2 30050676 90701614St James Hospital Clinic Mathai Mary MD 1645 Lutcher Ave Lutcher LA 70071 20 65 1 >10 2 1 2 30050676 90701614DALE ROBERT R DC Dale Robert R. DC 1959 Hwy 3125 Lutcher LA 70071 30 35 1 none 1 2 2 30060510 90703631THE PHYSICIAN'S ALLIANCE CORP (TPAC) Venturatos Steve G. 1111 Medical Center Blvd Suite S450 Marerro LA 70072 20 10 1 none 1 2 2 29891443 90095701JEFFERSON ORTHOPEDIC APPL 909 Avenue C Marerro LA 70072 40 53 1 none 1 2 2 29894691 90094660


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

CRESCENT CITY ANESTHESIA SERVICES 1101 MEDICAL CENTER BLVD MARRERO LA 70072 20 05 1 none 1 2 2 29891622 90095716THE PHYSICIAN'S ALLIANCE CORP (TPAC) 1101 Medical Center Blvd Marrero LA 70072 20 1T 1 none 1 2 2 29891622 90095716THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bryant Sara J. 1101 Medical Center Blvd Marrero LA 70072 20 37 1 <=18 1 2 1 29891622 90095716BURNS GERALD F MD Burns Gerald F. MD 1101 Medical Center Blvd Ste N103 Marrero LA 70072 35 65 1 none 1 2 2 29891622 90095716THE PHYSICIAN'S ALLIANCE CORP (TPAC) Desse Jean 1101 Medical Center Blvd Marrero LA 70072 20 41 1 >=18 1 2 2 29891622 90095716THE PHYSICIAN'S ALLIANCE CORP (TPAC) Everson Charles 1101 Medical Center Blvd Suite N703 Marrero LA 70072 20 33 1 none 1 2 2 29891622 90095716THE PHYSICIAN'S ALLIANCE CORP (TPAC) Le Kiet 1101 Medical Center Blvd Marrero LA 70072 20 41 1 >=18 1 2 2 29891622 90095716THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meadows M. Kathleen 1101 Medical Center Blvd Marrero LA 70072 20 37 1 <=18 1 2 2 29891622 90095716THE PHYSICIAN'S ALLIANCE CORP (TPAC) Saturno Emilio J. 1101 Medical Center Blvd Marrero LA 70072 20 37 1 <=18 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Aikman Kevin Paul CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Arcario Jane Ann CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Belair Charles M. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Benner Regina Fracchia CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Blanchard Steven Paul CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Bourgeois Becky Ann CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Brandt, Jr. Thomas Charles CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Breaux, Jr. Timothy Gerald CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Brennan Ann Marie MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Brennan Maureen Therese CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Brockhoeft Jacqueline L. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Brouillette Charlene V. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Callaway Lauren M. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Carriere Casey Breaux CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Carter Don Emile CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Celebi-Aiken Fatma Iris CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Celentano Wayne Joseph MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Comarda Neal G. MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Cook Louise Segura CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Dale Celeste A. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Denny Terri CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Ditta Melanie CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Ecuyer Richard Herbert CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Foster Carol CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Freeman James Carlton MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Friley Mary R. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Gaspard Jeffrey R. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Geisz-Everson Marjorie Ann CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Gillen Grant MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Goldenberg Thomas CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Harris, Jr. Eugene MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Harris, Jr. George Marion MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Hassenboehler Ardis Gordon CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Holtzman, Jr. Alan McKim CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES House, Sr. Glenn Anthony CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Hoz Philip D. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Krenz Elizabeth Ingrid MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Liu Henry MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Lockhart Melanie D. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Lombardi Nicole Angelle CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Mahony Patrick Mark CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

CRESCENT CITY ANESTHESIA SERVICES Majoue Chad Michael CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Martin Jennifer Bourgeios CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES May Tadd Alan CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Mimeles Derek MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Mollere James Patrick CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Monroe Karen Fray CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Montgomery Laura Ann CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Murphy Curt Andrew CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES O'Blanc Nicole Bruno CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Partesotti Sebastian Lawrence MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Paul Akkara Jose MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Puneky Allison Kinton CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Qunfoong Varaporn V. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Respess Shannon K. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Seay Robert Keith CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Shaver, Jr. David Vernon CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Steele Barry Alan MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Steele Kenneth John CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Tahir Ash H. MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Tanner April Jenell CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Thompson Candita Rogers FNP 1101 Medical Center Blvd. Marrero LA 70072 78 79 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Towns Peter Hughes MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Trosclair Chad Andrew CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Vadlamudi Ramamohana R. MD 1101 Medical Center Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Vicknair Joshua Wayne CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716CRESCENT CITY ANESTHESIA SERVICES Zimmerman Christopher V. CRNA 1101 Medical Center Blvd. Marrero LA 70072 91 05 1 none 1 2 1 29891622 90095716THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kimble John 1111 Medical Blvd Ste N406 Marrero LA 70072 20 04 1 none 1 2 1 29864545 90112319Parish Anesthesia West Bank, LLC 1111 Medical Center Blvd Marrero LA 70072 20 05 1 none 1 2 2 29891443 90095701NEW ORLEANS UROLOGIC INSTITUTE 1111 Medical Center Blvd Ste 313N Marrero LA 70072 20 34 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Applebaum Robert 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Atkins Steven 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Blackman Harris 1111 Medical Center Blvd Ste N401 Marrero LA 70072 20 07 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cain Brian 1111 Medical Center Blvd N507 Marrero LA 70072 32 48 1 none 1 2 2 29891443 90095701PHYSICIANS OPTICAL Caminita Larry J. OD 1111 Medical Center Blvd Ste 111 Marrero LA 70072 28 88 1 none 1 2 1 29891443 90095701NEW ORLEANS UROLOGIC INSTITUTE Caraway William A. MD 1111 Medical Center Blvd Ste 313N Marrero LA 70072 20 34 1 none 1 2 2 29891443 90095701NEW ORLEANS UROLOGIC INSTITUTE Chee Awai Ronald A. MD 1111 Medical Center Blvd Ste 313N Marrero LA 70072 20 34 1 none 1 2 1 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Colvin Meda 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Culicchia Frank 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 1 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cummiskey, III Robert 1111 Medical Center Blvd Suite 713n Marrero LA 70072 20 02 1 none 1 2 1 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Deltoro Kamill R. 1111 Medical Center Blvd Marrero LA 70072 20 37 1 <=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Deutsch Jules S. 1111 Medical Center Blvd Suite N313 Marrero LA 70072 20 34 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Divicenti Frank 1111 Medical Center Blvd Ste N713 Marrero LA 70072 20 02 1 none 1 2 2 29891443 90095701Ochsner Clinic Dupin Charles L. 1111 Medical Center Blvd Suite 640s Marrero LA 70072 20 02 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dupin Charles L. 1111 Medical Center Blvd Suite 640s Marrero LA 70072 20 24 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Edell Dean 1111 Medical Center Blvd Marrero LA 70072 20 37 1 <=18 1 2 1 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Falterman Chester DX 1111 Medical Center Blvd Suite N613 Marrero LA 70072 20 06 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Farris Kenneth 1111 Medical Center Blvd Ste S450 Marrero LA 70072 20 10 1 none 1 2 1 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ferris Samuel DX 1111 Medical Center Blvd Suite N613 Marrero LA 70072 20 06 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fiore, Jr. Ronald 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Freiberg John 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 2 29891443 90095701


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Glass Jon 1111 Medical Center Blvd Suite N311 Marrero LA 70072 20 34 1 none 1 2 2 29891443 90095701EYE ASSOCIATES OF WEST JEFFERSON Guarnieri Joseph MD 1111 Medical Center Blvd #N213 Marrero LA 70072 20 18 1 none 1 2 1 29891443 90095701NEW ORLEANS UROLOGIC INSTITUTE Hughes Stephanie E. MD 1111 Medical Center Blvd Ste 313N Marrero LA 70072 20 34 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hutchinson David B. 1111 Medical Center Blvd Suite N705 Marrero LA 70072 20 06 1 none 1 2 2 29891443 90095701WEST JEFFERSON ANESTHESIA Inuru Jayachandra R. MD 1111 Medical Center Blvd Ste N-105 Marrero LA 70072 20 05 1 none 1 2 1 29891443 90095701IRWIN, KIMBLE AND LONG Irwin Jr. Thomas M. MD 1111 Medical Center Blvd N406 Marrero LA 70072 20 04 1 none 1 2 1 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jackson Patrica A 1111 Medical Center Blvd Ste N 408 Marrero LA 70072 20 41 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jones Robert Walker 1111 Medical Center Blvd Ste N401 Marrero LA 70072 20 07 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kang Judy 1111 Medical Center Blvd Suite N504 Marrero LA 70072 20 29 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kedia Shantiprakas 1111 Medical Center Blvd Suite S450 Marrero LA 70072 20 10 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kessler Robert 1111 Medical Center Blvd Marrero LA 70072 20 2H 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Khan Abdul M. 1111 Medical Center Blvd Suite S450 Marrero LA 70072 20 10 1 none 1 2 2 29891443 90095701IRWIN, KIMBLE AND LONG Kimble John G. MD 1111 Medical Center Blvd N406 Marrero LA 70072 20 04 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kitahama Akio 1111 Medical Center Blvd N403 Marrero LA 70072 20 02 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Labadie Pablo 1111 Medical Center Blvd Suite N311 Marrero LA 70072 20 34 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lanasa Elaine 1111 Medical Center Blvd Suite N504 Marrero LA 70072 20 29 1 none 1 2 2 29891443 90095701NEW ORLEANS UROLOGIC INSTITUTE Landry Glenn R. MD 1111 Medical Center Blvd Ste 313N Marrero LA 70072 20 34 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lebrun Michel 1111 Medical Center Blvd Suite N504 Marrero LA 70072 20 29 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lefort Athena 1111 Medical Center Blvd Marrero LA 70072 20 37 1 <=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lilly James D. 1111 Medical Center Blvd Suite S450 Marrero LA 70072 20 10 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Long Anne 1111 Medical Center Blvd Ste N406 Marrero LA 70072 20 04 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mallik Tilak 1111 Medical Center Blvd Suite S113 Marrero LA 70072 20 2E 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Marino Mark 1111 Medical Center Blvd Suite S450 Marrero LA 70072 20 10 1 none 1 2 2 29891443 90095701Deepthi Murthy MD APMC Murthy Deepthi MD 1111 Medical Center Blvd Ste N809 Marrero LA 70072 20 2I 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nicholson-Uhl Craig James 1111 Medical Center Blvd Marrero LA 70072 78 08 1 None 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Puente Michael 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 2 29891443 90095701MICHAEL G RUSSO MD Russo Michael 1111 Medical Center Blvd Marrero LA 70072 20 08 1 None 1 2 1 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rynick Stephen 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schibler Charles G. 1111 Medical Center Blvd Ste S450 Marrero LA 70072 20 10 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sinclair Heidi 1111 Medical Center Blvd Marrero LA 70072 20 41 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith George 1111 Medical Center Blvd Ste 350s Marrero LA 70072 20 06 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Steck John 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Theis James 1111 Medical Center Blvd Suite N408 Marrero LA 70072 20 08 1 None 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Toomer Andrea 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Truax Walter 1111 Medical Center Blvd Ste S750 Marrero LA 70072 20 13 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Workman Mark 1111 Medical Center Blvd Marrero LA 70072 20 2I 1 none 1 2 2 29891443 90095701CARDIOLOGY CENTER 1111 Medical Center Blvd 350-S Marrero LA 70072 20 06 1 none 1 2 2 29884195 90131696MICHAEL HAYDEL MD AMC Capone Kenneth J. 1111 Medical Center Blvd N 208 Marrero LA 70072 20 37 1 <=18 1 2 1 29845998 90113116MICHAEL HAYDEL MD AMC Fantaci Lindsay York 1111 Medical Center Blvd N 208 Marrero LA 70072 20 37 1 <=18 1 2 1 29845998 90113116MICHAEL HAYDEL MD AMC Haydel Michael P. 1111 Medical Center Blvd N 208 Marrero LA 70072 20 37 1 <=18 1 2 1 29845998 90113116WEST JEFFERSON SURGERY CENTER 1111 Medical Center Blvd. Ste. N-105 Marrero LA 70072 20 02 1 none 1 2 1 29891443 90095701ACIKALIN TAMER MD Acikalin Tamer MD 1111 Medical Center Blvd. Suite N-306 Marrero LA 70072 20 10 1 >=18 1 2 1 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Batson Robert C. 1111 Medical Center Blvd. Suite 713 N Marrero LA 70072 20 2P 1 none 1 2 2 29891443 90095701Ochsner Clinic Bazan Herman A. 1111 Medical Center Blvd. Suite N713 Marrero LA 70072 20 2P 1 none 1 2 1 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bazan Hernan A. 1111 Medical Center Blvd. Suite N713 Marrero LA 70072 20 02 1 none 1 2 2 29891443 90095701MEDA COLVIN LLC Colvin Meda 1111 Medical Center Blvd. Ste. S555 Marrero LA 70072 35 65 1 >=18 1 2 2 29891443 90095701CORTEZ MARIA A., MD Cortez Maria A. MD 1111 Medical Center Blvd. Ste. N501 Marrero LA 70072 20 16 1 >=16 1 2 1 29891443 90095701LABADIE & LABADIE Decoursey Mary Alice CNM 1111 Medical Center Blvd. Suite 250-South Marrero LA 70072 78 16 1 >=16 1 2 1 29891443 90095701LABADIE & LABADIE Labadie Eugenio C. MD 1111 Medical Center Blvd. Suite 250-South Marrero LA 70072 20 16 1 >=16 1 2 1 29891443 90095701LABADIE & LABADIE Labadie Juan J. MD 1111 Medical Center Blvd. Suite 250-South Marrero LA 70072 20 16 1 >=16 1 2 2 29891443 90095701


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

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THE PHYSICIAN'S ALLIANCE CORP (TPAC) Palit Tapash K. 1111 Medical Center Blvd. Suite N713 Marrero LA 70072 20 2P 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Richter Erich O. 1111 Medical Center Blvd. Suite S-750 Marrero LA 70072 20 14 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sheahan Claudie S. 1111 Medical Center Blvd. Suite N713 Marrero LA 70072 20 33 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sheahan Malachi G. 1111 Medical Center Blvd. Suite N713 Marrero LA 70072 20 33 1 none 1 2 2 29891443 90095701LABADIE & LABADIE Simani Yuri MD 1111 Medical Center Blvd. Suite 250-South Marrero LA 70072 20 16 1 >=16 1 2 2 29891443 90095701LABADIE & LABADIE Vaughan Amy E. MD 1111 Medical Center Blvd. Suite 250-South Marrero LA 70072 20 16 1 >=16 1 2 1 29891443 90095701CARDIOLOGY CENTER Dravid Sanjay MD 1111 Medical Center Blvd. 350-S Marrero LA 70072 20 06 1 >=18 1 2 2 29852934 90109241CARDIOLOGY CENTER Rodriguez-Fierro Carlos MD 1111 Medical Center Blvd. 350-S Marrero LA 70072 20 06 1 >=18 1 2 2 29852934 90109241BOOS THOMAS A MD Kappelman Mark D. 1111 Medical Center Blvd. N-310 Marrero LA 70072 20 02 1 none 1 2 2 29890498 90115620BOOS THOMAS A MD Minnard Emery A. 1111 Medical Center Blvd. N-310 Marrero LA 70072 20 02 1 none 1 2 2 29890498 90115620BOOS THOMAS A MD Sherafgan Kashaf 1111 Medical Center Blvd. N-310 Marrero LA 70072 20 02 1 none 1 2 2 29890498 90115620HEART CLINIC OF LOUISIANA Cospolich Brian MD 1111 Medical Center Blvd., #613N Marrero LA 70072 20 06 1 >=18 1 2 1 29891443 90095701HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Cospolich Brian J. MD 1111 Medical Center Blvd., #613N Marrero LA 70072 20 06 1 >=18 1 2 1 29891443 90095701HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Glade Louis B. MD 1111 Medical Center Blvd., #613N Marrero LA 70072 20 06 1 >=18 1 2 2 29891443 90095701HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Kerut Edmund K. MD 1111 Medical Center Blvd., #613N Marrero LA 70072 20 06 1 >=18 1 2 1 29891443 90095701HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Kushner Frederick G. MD 1111 Medical Center Blvd., #613N Marrero LA 70072 20 06 1 >=18 1 2 2 29891443 90095701HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES LaGuardia Stephen P. MD 1111 Medical Center Blvd., #613N Marrero LA 70072 20 06 1 >=18 1 2 2 29891443 90095701HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Levenson Leslie W. MD 1111 Medical Center Blvd., #613N Marrero LA 70072 20 06 1 >=18 1 2 2 29891443 90095701HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Matheney Robert D. MD 1111 Medical Center Blvd., #613N Marrero LA 70072 20 06 1 >=18 1 2 2 29891443 90095701HEART CLINIC OF LOUISIANA DIAGNOSTIC SERVICES Stein Maureen W. MD 1111 Medical Center Blvd., #613N Marrero LA 70072 20 06 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pollack Scott 1111 Medical Ceter Blvd Suite 5450 Marrero LA 70072 20 10 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reddy Sanjeeva 1111 Medical Ceter Blvd Suite 5450 Marrero LA 70072 20 10 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Le Trac 1111 Medical Ctr N Tower 511 Marrero LA 70072 20 2K 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Acosta Scott 1111 Medical Ctr Blvd Marrero LA 70072 20 41 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Borron William 1111 Medical Ctr Blvd Ste N504 Marrero LA 70072 20 29 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bowers Alan 1111 Medical Ctr Blvd Marrero LA 70072 20 41 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cabrera Hector 1111 Medical Ctr Blvd Marrero LA 70072 20 08 1 None 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cashman Cory 1111 Medical Ctr Blvd Ste N-340 Marrero LA 70072 20 41 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chandrasekaran Nagarajan 1111 Medical Ctr Blvd S-630 Marrero LA 70072 20 2H 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ellent Libby 1111 Medical Ctr Blvd Suite N308 Marrero LA 70072 20 41 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Elliott Denise 1111 Medical Ctr Blvd N507 Marrero LA 70072 32 48 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Holmes Jimmie 1111 Medical Ctr Blvd Marrero LA 70072 20 41 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Seiler, Jr Milton 1111 Medical Ctr Blvd #s-630 Marrero LA 70072 20 2H 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Spedale Sandra 1111 Medical Ctr Blvd Marrero LA 70072 20 41 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tanenbaum Rian M. 1111 Medical Ctr Blvd Ste S450 Marrero LA 70072 20 10 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thomas Charles W. 1111 Medical Ctr Blvd N713 Marrero LA 70072 20 02 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wright Patricia 1111 Medical Ctr Blvd Marrero LA 70072 20 41 1 >=18 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Irwin, Jr. Thomas 1111 Medical Ctr Blvd #n40 Marrero LA 70072 20 04 1 none 1 2 1 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Waits Stefany 1111 Medical Ctr Blvd #n40 Marrero LA 70072 20 04 1 none 1 2 2 29891443 90095701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lemann Rebekah H. 111111 Medical Center Blvd Ste 5450 Marrero LA 70072 20 10 1 none 1 2 2 29884470 90098542WESTCARE MEDICAL CENTER Arnold Jeffery C. FNP 1220 Barataria Blvd Marrero LA 70072 78 08 1 >=18 1 2 1 29888862 90099853WESTCARE MEDICAL CENTER Becnel Roland H. RN, FNP 1220 Barataria Blvd Marrero LA 70072 78 08 1 >=18 1 2 1 29888862 90099853WESTCARE MEDICAL CENTER Hoover Bendel C. DPM 1220 Barataria Blvd Marrero LA 70072 32 48 1 none 1 2 1 29888862 90099853WESTCARE MEDICAL CENTER Rachal Dionne M. FNP 1220 Barataria Blvd Marrero LA 70072 78 08 1 >=18 1 2 2 29888862 90099853WESTCARE MEDICAL CENTER Yancy Brigetta D. MD 1220 Barataria Blvd Marrero LA 70072 20 08 1 None 1 2 1 29888862 90099853WESTCARE MEDICAL CENTER Friley Michael D. MD 1220 Barataria Blvd. Marrero LA 70072 20 08 1 None 1 2 1 29888862 90099853WESTCARE MEDICAL CENTER Procell William R. MD 1220 Barataria Blvd. Marrero LA 70072 20 08 1 None 1 2 1 29888862 90099853THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reza Ali 1301 Barataria Blvd Marrero LA 70072 20 06 1 none 1 2 1 29887854 90099214DOROTHY K ANDERSON OD Anderson Dorothy K. OD 1670 Barataria Blvd Ste D Marrero LA 70072 28 88 1 none 1 2 2 29879927 90098924DOROTHY K ANDERSON OD Beam Amy C. OD 1670 Baratoria Blvd Ste D Marrero LA 70072 28 88 1 none 1 2 2 29879927 90098924


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Jefferson Community Health Care Centers 1855 Ames Blvd. Marrero LA 70072 72 9L 1 none 1 2 2 29881792 90113968Jefferson Community Health Care Centers Allen Renetta 1855 Ames Blvd. Marrero LA 70072 78 08 1 None 1 2 2 29881792 90113968Jefferson Community Health Care Centers Curole David MD 1855 Ames Blvd. Marrero LA 70072 20 16 1 >=16 1 2 1 29881792 90113968Jefferson Community Health Care Centers Dumas Jeremy MD 1855 Ames Blvd. Marrero LA 70072 20 41 1 >=18 1 2 2 29881792 90113968Jefferson Community Health Care Centers McNeil Vonder 1855 Ames Blvd. Marrero LA 70072 78 08 1 None 1 2 2 29881792 90113968Jefferson Community Health Care Centers Pandit Bharathi MD 1855 Ames Blvd. Marrero LA 70072 20 37 1 <=18 1 2 2 29881792 90113968Jefferson Community Health Care Centers Price Genelle MD 1855 Ames Blvd. Marrero LA 70072 20 41 1 >=18 1 2 2 29881792 90113968Jefferson Community Health Care Centers Salgado Maritza NP 1855 Ames Blvd. Marrero LA 70072 78 08 1 None 1 2 2 29881792 90113968Jefferson Community Health Care Centers Verrett LaJuan 1855 Ames Blvd. Marrero LA 70072 78 08 1 None 1 2 2 29881792 90113968Jefferson Community Health Care Centers Warrier Jaya MD 1855 Ames Blvd. Marrero LA 70072 20 08 1 None 1 2 2 29881792 90113968Jefferson Community Health Care Centers Wolfson Neil MD 1855 Ames Blvd. Marrero LA 70072 20 16 1 >=16 1 2 2 29881792 90113968Ochsner Clinic Boinapally Vaidehi 4225 Lapalco Blvd. Marrero LA 70072 20 41 1 >=18 1 2 2 29874484 90091807Ochsner Clinic Burns C. Braddock 4225 Lapalco Blvd. Marrero LA 70072 20 29 1 none 1 2 2 29874484 90091807Ochsner Clinic Canfield Phillip R. 4225 Lapalco Blvd. Marrero LA 70072 20 08 1 None 1 2 2 29874484 90091807Ochsner Clinic Davis Emma 4225 Lapalco Blvd. Marrero LA 70072 78 08 1 None 1 2 2 29874484 90091807Ochsner Clinic Ehrensing Craig A. 4225 Lapalco Blvd. Marrero LA 70072 20 41 1 >=18 1 2 2 29874484 90091807Ochsner Clinic Guillmette Jeffery A. 4225 Lapalco Blvd. Marrero LA 70072 20 18 1 none 1 2 2 29874484 90091807Ochsner Clinic Hecker Maureen 4225 Lapalco Blvd. Marrero LA 70072 20 41 1 >=18 1 2 2 29874484 90091807Ochsner Clinic Kelly Robert M. 4225 Lapalco Blvd. Marrero LA 70072 28 88 1 none 1 2 2 29874484 90091807Ochsner Clinic Khatib Sammy 4225 Lapalco Blvd. Marrero LA 70072 20 06 1 none 1 2 2 29874484 90091807Ochsner Clinic Laborde Yvens G. 4225 Lapalco Blvd. Marrero LA 70072 20 41 1 >=18 1 2 2 29874484 90091807Ochsner Clinic Lagarde May Michele T. 4225 Lapalco Blvd. Marrero LA 70072 20 08 1 None 1 2 2 29874484 90091807Ochsner Clinic Lao Elie Y. 4225 Lapalco Blvd. Marrero LA 70072 20 08 1 None 1 2 2 29874484 90091807Ochsner Clinic Lavie, Jr. Carl J. 4225 Lapalco Blvd. Marrero LA 70072 20 06 1 none 1 2 2 29874484 90091807Ochsner Clinic Marquis Paul J. 4225 Lapalco Blvd. Marrero LA 70072 20 08 1 None 1 2 2 29874484 90091807Ochsner Clinic Osinbowale Olsugun O. 4225 Lapalco Blvd. Marrero LA 70072 20 06 1 none 1 2 2 29874484 90091807Ochsner Clinic Perry Anthony G. 4225 Lapalco Blvd. Marrero LA 70072 32 48 1 none 1 2 2 29874484 90091807Ochsner Clinic Prats, Jr. Lester J. 4225 Lapalco Blvd. Marrero LA 70072 20 34 1 none 1 2 2 29874484 90091807Ochsner Clinic Quintal Craig J. 4225 Lapalco Blvd. Marrero LA 70072 28 88 1 none 1 2 2 29874484 90091807Ochsner Clinic Racz Roger S. 4225 Lapalco Blvd. Marrero LA 70072 32 48 1 none 1 2 2 29874484 90091807Ochsner Clinic Sanders Geremy L. 4225 Lapalco Blvd. Marrero LA 70072 20 05 1 none 1 2 2 29874484 90091807Ochsner Clinic Scott Jarelle M. 4225 Lapalco Blvd. Marrero LA 70072 20 08 1 None 1 2 2 29874484 90091807Ochsner Clinic Snyder Christopher S. 4225 Lapalco Blvd. Marrero LA 70072 20 06 1 none 1 2 1 29874484 90091807Ochsner Clinic Sus Rachana N. 4225 Lapalco Blvd. Marrero LA 70072 20 41 1 >=18 1 2 2 29874484 90091807Ochsner Clinic Urrego Fernando A. 4225 Lapalco Blvd. Marrero LA 70072 20 29 1 none 1 2 1 29874484 90091807Ochsner Clinic Vanlangendonck, Jr. Richard M. 4225 Lapalco Blvd. Marrero LA 70072 20 34 1 none 1 2 2 29874484 90091807Ochsner Clinic Williams Chequita S. 4225 Lapalco Blvd. Marrero LA 70072 20 08 1 None 1 2 2 29874484 90091807Ochsner Clinic Winkeler Laura A. 4225 Lapalco Blvd. Marrero LA 70072 20 41 1 >=18 1 2 2 29874484 90091807Ochsner Clinic Young Thomas W. 4225 Lapalco Blvd. Marrero LA 70072 20 1D 1 none 1 2 1 29874484 90091807JEFFERSON PARISH SBHC - BONNABEL SBHC Robinson Wanda 4300 Patriot St Marrero LA 70072 20 37 1 <=18 1 2 2 29882711 90091146THE PHYSICIAN'S ALLIANCE CORP (TPAC) Digrado Joseph 4500 10th St Marrero LA 70072 20 20 1 none 1 2 2 29892968 90094653THE PHYSICIAN'S ALLIANCE CORP (TPAC) Katz Ralph 4500 10th St Marrero LA 70072 20 20 1 none 1 2 2 29892968 90094653THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sanchez Fernando 4500 10th St Marrero LA 70072 20 20 1 none 1 2 2 29892968 90094653LABCORP 4520 WICHERS DR STE 103 MARRERO LA 70072 20 30 1 none 1 1 2 29889365 90094486TAKE CARE HEALTH LOUISIANA 4600 Westbank Expressway Marrero LA 70072 78 08 1 none 1 2 2 29895460 90096580BONE & JOINT CLINIC OF NEW ORLEANS Boyd Roderick S. 4633 Wichers Dr Marrero LA 70072 35 65 1 none 1 2 2 29889575 90095470BONE & JOINT CLINIC OF NEW ORLEANS Segura Ronald C. MD 4633 Wichers Dr Marrero LA 70072 20 05 1 none 1 2 2 29889575 90095470BONE & JOINT CLINIC OF NEW ORLEANS Gallager Daniel J. MD 4633 Wichers Dr. Marrero LA 70072 20 20 1 none 1 2 2 29889575 90095470BONE & JOINT CLINIC OF NEW ORLEANS Habetz Scott J. MD 4633 Wichers Dr. Marrero LA 70072 20 20 1 none 1 2 2 29889575 90095470BONE & JOINT CLINIC OF NEW ORLEANS Robert, III Kearny D. MD 4633 Wichers Dr. Marrero LA 70072 20 20 1 none 1 2 2 29889575 90095470


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

BONE & JOINT CLINIC OF NEW ORLEANS Rozas Earl J. MD 4633 Wichers Dr. Marrero LA 70072 20 20 1 none 1 2 2 29889575 90095470BONE & JOINT CLINIC OF NEW ORLEANS Shackelton Robert L. MD 4633 Wichers Dr. Marrero LA 70072 20 20 1 none 1 2 2 29889575 90095470BONE & JOINT CLINIC OF NEW ORLEANS Todd, III James M. MD 4633 Wichers Dr. Marrero LA 70072 20 20 1 none 1 2 2 29889575 90095470Quest Diagnostics 4700 Wichers Dr Marrero LA 70072 20 30 1 none 1 1 2 29889190 90096962ST CHARLES COMMUNITY HEALTH CENTER 941 First Street Norco LA 70079 72 9L 1 none 1 2 1 29999177 90413110ST CHARLES COMMUNITY HEALTH CENTER Hadi Mohammed MD 941 First Street Norco LA 70079 20 08 1 None 1 2 2 29999177 90413110ST CHARLES COMMUNITY HEALTH CENTER Huarcaya Erick MD 941 First Street Norco LA 70079 20 08 1 None 1 2 1 29999177 90413110ST CHARLES COMMUNITY HEALTH CENTER Joseph Kevin O. MD 941 First Street Norco LA 70079 20 08 1 None 1 2 1 29999177 90413110ST CHARLES COMMUNITY HEALTH CENTER Lawrence Shona NP 941 First Street Norco LA 70079 78 08 1 None 1 2 2 29999177 90413110ST CHARLES COMMUNITY HEALTH CENTER Mardia Sudha MD 941 First Street Norco LA 70079 20 08 1 None 1 2 1 29999177 90413110ST CHARLES COMMUNITY HEALTH CENTER Nachabe Moustafa MD 941 First Street Norco LA 70079 20 37 1 <=18 1 2 1 29999177 90413110ST CHARLES COMMUNITY HEALTH CENTER Parquet Kawander NP 941 First Street Norco LA 70079 78 08 1 None 1 2 2 29999177 90413110ST CHARLES COMMUNITY HEALTH CENTER Sadeghpour Bahram MD 941 First Street Norco LA 70079 20 37 1 <=18 1 2 1 29999177 90413110FAMILY MEDICINE CENTER OF RESERVE Albrecht Robert C. MD 147 Central Ave Reserve LA 70084 20 08 1 none 1 2 1 30054511 90551765FAMILY MEDICINE CENTER OF RESERVE 147 Central Avenue Reserve LA 70084 79 94 1 none 1 2 2 30054511 90551765TECHE ACTION CLINIC Walker Patrick D. 471 Central Avenue Reserve LA 70084 20 41 1 >=16 1 2 1 30061206 90551991TECHE ACTION CLINIC 471 Centtral Avenue Reserve LA 70084 72 9L 1 none 1 2 1 30061206 90551991TECHE ACTION CLINIC Brignac Jeanenne C. 471 Centtral Avenue Reserve LA 70084 20 08 1 None 1 2 1 30061206 90551991TECHE ACTION CLINIC Bustillo Mayra S. 471 Centtral Avenue Reserve LA 70084 20 37 1 <=18 1 2 2 30061206 90551991TECHE ACTION CLINIC Clay Lori W. 471 Centtral Avenue Reserve LA 70084 78 08 1 None 1 2 1 30061206 90551991TECHE ACTION CLINIC Clay Melissa W. 471 Centtral Avenue Reserve LA 70084 78 08 1 None 1 2 2 30061206 90551991TECHE ACTION CLINIC Delgado Guillermo E. CRNA 471 Centtral Avenue Reserve LA 70084 20 16 1 >=16 1 2 2 30061206 90551991TECHE ACTION CLINIC Eure Elizabeth C. 471 Centtral Avenue Reserve LA 70084 78 08 1 None 1 2 2 30061206 90551991TECHE ACTION CLINIC Fabre Jennifer C. 471 Centtral Avenue Reserve LA 70084 78 08 1 >=18 1 2 2 30061206 90551991TECHE ACTION CLINIC Gautam Chatshu 471 Centtral Avenue Reserve LA 70084 20 08 1 None 1 2 1 30061206 90551991TECHE ACTION CLINIC Gisclair Heather R. 471 Centtral Avenue Reserve LA 70084 78 08 1 None 1 2 2 30061206 90551991TECHE ACTION CLINIC Hinds Trenton A. 471 Centtral Avenue Reserve LA 70084 20 41 1 >=18 1 2 2 30061206 90551991TECHE ACTION CLINIC Miller Candice M. 471 Centtral Avenue Reserve LA 70084 78 08 1 >=18 1 2 1 30061206 90551991TECHE ACTION CLINIC Millet Jennifer R. 471 Centtral Avenue Reserve LA 70084 78 08 1 None 1 2 2 30061206 90551991TECHE ACTION CLINIC Molinere Stacey B. 471 Centtral Avenue Reserve LA 70084 78 08 1 None 1 2 2 30061206 90551991TECHE ACTION CLINIC Morgan Cara M. 471 Centtral Avenue Reserve LA 70084 20 08 1 None 1 2 1 30061206 90551991TECHE ACTION CLINIC Wiltz Gary M. 471 Centtral Avenue Reserve LA 70084 20 41 1 >=18 1 2 2 30061206 90551991ST CHARLES COMMUNITY HEALTH CENTER 232 Pirate Drive St. Rose LA 70087 72 9L 1 none 1 2 1 29957083 90308279ST CHARLES COMMUNITY HEALTH CENTER Falgout Amie NP 232 Pirate Drive St. Rose LA 70087 78 79 1 >=18 1 2 2 29957083 90308279ST CHARLES COMMUNITY HEALTH CENTER Hadi Mohammed MD 232 Pirate Drive St. Rose LA 70087 20 08 1 None 1 2 2 29957083 90308279ST CHARLES COMMUNITY HEALTH CENTER Huarcaya Erick MD 232 Pirate Drive St. Rose LA 70087 20 08 1 None 1 2 1 29957083 90308279ST CHARLES COMMUNITY HEALTH CENTER Joseph Kevin O. MD 232 Pirate Drive St. Rose LA 70087 20 08 1 None 1 2 1 29957083 90308279ST CHARLES COMMUNITY HEALTH CENTER Mardia Sudha MD 232 Pirate Drive St. Rose LA 70087 20 08 1 None 1 2 1 29957083 90308279ST CHARLES COMMUNITY HEALTH CENTER Nachabe Moustafa MD 232 Pirate Drive St. Rose LA 70087 20 37 1 <=18 1 2 1 29957083 90308279ST CHARLES COMMUNITY HEALTH CENTER Sadeghpour Bahram MD 232 Pirate Drive St. Rose LA 70087 20 37 1 <=18 1 2 1 29957083 90308279ST PHILIP CLINIC Waguespack, Jr. Roland S. 1108 St. James St Vacherie LA 70090 20 08 1 None 1 2 1 29943071 90696800S K DONEPUDI MD APMC Donepudi Sarat K. MD 21420 Hwy 20 Vacherie LA 70090 20 08 1 None 1 2 1 29966235 90714665Jefferson Community Health Care Centers 4028 US Highway 90 Avondale LA 70094 72 9L 1 none 1 2 2 29911495 90224347Jefferson Community Health Care Centers Allen Renetta 4028 US Highway 90 Avondale LA 70094 78 08 1 None 1 2 2 29911495 90224347Jefferson Community Health Care Centers Curole David MD 4028 US Highway 90 Avondale LA 70094 20 16 1 >=16 1 2 1 29911495 90224347Jefferson Community Health Care Centers Dumas Jeremy MD 4028 US Highway 90 Avondale LA 70094 20 41 1 >=18 1 2 2 29911495 90224347Jefferson Community Health Care Centers McNeil Vonder 4028 US Highway 90 Avondale LA 70094 78 08 1 None 1 2 2 29911495 90224347Jefferson Community Health Care Centers Pandit Bharathi MD 4028 US Highway 90 Avondale LA 70094 20 37 1 <=18 1 2 2 29911495 90224347Jefferson Community Health Care Centers Price Genelle MD 4028 US Highway 90 Avondale LA 70094 20 41 1 >=18 1 2 2 29911495 90224347Jefferson Community Health Care Centers Salgado Maritza NP 4028 US Highway 90 Avondale LA 70094 78 08 1 None 1 2 2 29911495 90224347


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Jefferson Community Health Care Centers Verrett LaJuan 4028 US Highway 90 Avondale LA 70094 78 08 1 None 1 2 2 29911495 90224347Jefferson Community Health Care Centers Warrier Jaya MD 4028 US Highway 90 Avondale LA 70094 20 08 1 None 1 2 2 29911495 90224347Jefferson Community Health Care Centers Wolfson Neil MD 4028 US Highway 90 Avondale LA 70094 20 16 1 >=16 1 2 2 29911495 90224347JEFFERSON PARISH SBHC - BONNABEL SBHC Peterson Tina 300 4th St Westwego LA 70094 78 79 1 >=18 1 2 2 29932216 90167108JEFFERSON PARISH SBHC - BONNABEL SBHC Weimer Steven 300 4th St Westwego LA 70094 20 37 1 <=18 1 2 2 29932216 90167108WESTCARE MEDICAL CENTER 712 West Bank Expressway Westwego LA 70094 20 08 1 None 1 2 1 29898308 90145404WESTCARE MEDICAL CENTER Arnold Jeffery C. FNP 712 West Bank Expressway Westwego LA 70094 78 08 1 >=18 1 2 1 29898308 90145404WESTCARE MEDICAL CENTER Hoover Bendel C. DPM 712 West Bank Expressway Westwego LA 70094 32 48 1 none 1 2 1 29898308 90145404WESTCARE MEDICAL CENTER Procell William R. MD 712 West Bank Expressway Westwego LA 70094 20 08 1 None 1 2 1 29898308 90145404WESTCARE MEDICAL CENTER Rachal Dionne M. FNP 712 West Bank Expressway Westwego LA 70094 78 08 1 >=18 1 2 2 29898308 90145404WESTCARE MEDICAL CENTER Yancy Brigetta D. MD 712 Westbank Expressway Westwego LA 70094 20 08 1 None 1 2 1 29898308 90145404TUHC ANESTHESIOLOGY GROUP, LLC ADHIKARI Laura CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC ALCHEDIAK Thomas MD 1415 Tulane Avenue TW-35 New Orleans LA 70112 20 41 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC ALPER Arnold MD 1415 Tulane Avenue TW-35 New Orleans LA 70112 20 2K 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC ANDERSON Dwayne MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC ARCARIO Jane Ann CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC BADEAUX Jennifer CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC BADON Betty CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC BEECH Scott MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC BENT Sabrina MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC BILLINGS Charles MD 1415 Tulane Avenue HC-09 New Orleans LA 70112 20 20 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC BLANK Barry MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC BRANTING Scott MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC BREAUX Timothy CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC BROCKHOEFT Jacqueline CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC BURDICK Michael MD 1415 Tulane Avenue HC-62 New Orleans LA 70112 20 2J 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC BURKE Kimberly CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC CANTRELL Barbara CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC CASEY Virginia CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC CHANDLER Ermine CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC CHANG Tiffany MD 1415 Tulane Avenue HC-53 New Orleans LA 70112 20 13 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC CHETTA Brenda CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC COLON-GARCIA Patricia MD 1415 Tulane Avenue HC-20 New Orleans LA 70112 20 13 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC COOK John MD 1415 Tulane Avenue HC-48 New Orleans LA 70112 20 06 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC COUGLE Christopher MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC DALHOUSE Martha CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC DANG Son MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC DENNY Catherine CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC ELLIS Michael MD 1415 Tulane Avenue HC-76 New Orleans LA 70112 20 04 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC ELLIS-HUGHES Vicky CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC EVANS Karen CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC FALATI Constance CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC FERNANDES Bernard CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC FOX Charles MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC FRIEDLANDER Miles MD 1415 Tulane Avenue HC-38 New Orleans LA 70112 20 18 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC FUSSELL Howard CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC GARDINER Scott MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC GILLANE Jacqueline CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC GOMEZ Santiago MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC GUERINGER Marie CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

TUHC PHYSICIAN GROUP, LLC HANEMANN Cynthia MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC HANSEN Robert MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC HOBBS Darlene CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC HOLTZMAN Alan CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC ILLG Natalie CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC JACOBS Alan MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC JOHNSTON Sean MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC JONES Lyndia MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC KALARICKAL Philip MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC KALIL David CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC KARL Deanna MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC KENNEDY Latosha CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC KOVELESKIE Joseph MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC LAMBERT Candis CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC LAPEYROUSE Michelle CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC LAZARO Stephen MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC LEDET Lloyd CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC LESAICHERRE Ryan CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC LEWIS Kourtney CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC LIU Henry MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC LUKITSCH Ivo MD 1415 Tulane Avenue TW-35 New Orleans LA 70112 20 2K 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC LUTFALLAH Chantal MD 1415 Tulane Avenue HC-44 New Orleans LA 70112 20 2E 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC LYNCH Jeremy CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC MAJORIA Ryan MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC MALLIKARJUN Chaithanya MD 1415 Tulane Avenue TW-35 New Orleans LA 70112 20 10 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC MARTIN Gayle CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC MCCLURE Brian MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC MCCONVILLE Anne MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC MCNABB Leslee MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC MORAN Patrick CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC MURPHY Curt CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC MUSTIN Harold CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC NELSON Stephen MD 1415 Tulane Avenue HC-58 New Orleans LA 70112 20 13 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC NGUYEN Jeremy MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC O'BRIEN Kirstie CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC O'MALLEY Angela CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC O'NEILL Rosalinda CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC PALACIOS Enrique MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC PIERRE Nakeisha MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC PORTER Chad MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC POSEY John MD 1415 Tulane Avenue HC-53 New Orleans LA 70112 20 13 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC PRIMEAUX Paul MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC REGENSTEIN Fredric MD 1415 Tulane Avenue HC-35 New Orleans LA 70112 20 10 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC RICHARD Randall CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC RODRIGUEZ Kimsey MD 1415 Tulane Avenue HC-76 New Orleans LA 70112 20 04 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC ROSATO James CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC ROSENBERRY Cynthia CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC ROSINIA Francis MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC SCHLUTER Laurie NP 1415 Tulane Avenue HC-36 New Orleans LA 70112 78 08 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC SCHUBER Scott MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

TUHC PHYSICIAN GROUP, LLC SCHULINGKAMP Amy NP 1415 Tulane Avenue HC-48 New Orleans LA 70112 78 08 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC SEROU Michael MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC SHAH Basil MD 1415 Tulane Avenue HC-16 New Orleans LA 70112 20 30 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC STICKER James CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC STRICKLAND Theodore MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC TAHIR Michael MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC TAQUINO Pauline CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC TOLEDANO Roulhac MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC TORTORICH Frank CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC TUITE Meaghan CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC VICKNAIR Joshua CRNA 1415 Tulane Avenue HC-73 New Orleans LA 70112 91 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC WEED Jonathan MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC WEIMER Stephen MD 1415 Tulane Avenue TW-35 New Orleans LA 70112 20 37 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC YARBOROUGH Michael MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC ANESTHESIOLOGY GROUP, LLC YOUNG Elizabeth MD 1415 Tulane Avenue HC-73 New Orleans LA 70112 20 05 1 none 1 1 2 29955436 90076153TUHC PHYSICIAN GROUP, LLC KRAUS Stephen MD 150 South Liberty Street HC-62 New Orleans LA 70112 20 2J 1 none 1 1 2 29956453 90074735TUHC PHYSICIAN GROUP, LLC WASHINGTON Alexander MD 150 South Liberty Street HC-62 New Orleans LA 70112 20 2H 1 none 1 1 2 29956453 90074735TUHC PHYSICIAN GROUP, LLC CRAFT Lisa NP 275 LaSalle Street HC-53 New Orleans LA 70112 78 08 1 none 1 1 2 29955984 90076812TUHC PHYSICIAN GROUP, LLC HEBERT Corey MD 275 LaSalle Street HC-57 New Orleans LA 70112 20 37 1 none 1 1 2 29955984 90076812THE PHYSICIAN'S ALLIANCE CORP (TPAC) Clark Rebecca A. New Orleans LA 70112 20 41 1 >=18 1 2 2 29957838 90083024THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hagensee Michael E. New Orleans LA 70112 20 41 1 >=18 1 2 2 29962994 90077614THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lopez Alfredo A. New Orleans LA 70112 20 41 1 >=18 1 2 2 29957878 90072038THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wilcox Ronald D. New Orleans LA 70112 20 41 1 >=18 1 2 2 29952384 90078946THE PHYSICIAN'S ALLIANCE CORP (TPAC) Besch Ceryl L. 136 S. Roman Street, 2nd Floor New Orleans LA 70112 20 2I 1 none 1 2 2 29962465 90071902THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campusano Socrates Zapata 136 S. Roman Street, 2nd Floor New Orleans LA 70112 20 2I 1 none 1 2 2 29962465 90071902NO / AIDS TASK FORCE Campusano Socrates Zapata 136 S. Roman Street, 2nd Floor New Orleans LA 70112 35 65 1 none 1 2 2 29962465 90071902THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dargis Julie A. 136 S. Roman Street, 2nd Floor New Orleans LA 70112 78 08 1 none 1 2 2 29962465 90071902THE PHYSICIAN'S ALLIANCE CORP (TPAC) Figueroa Julio E. 136 S. Roman Street, 2nd Floor New Orleans LA 70112 20 2I 1 none 1 2 2 29962465 90071902THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hull Anne E. 136 S. Roman Street, 2nd Floor New Orleans LA 70112 20 2I 1 none 1 2 2 29962465 90071902THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hull Anne 136 S. Roman Street, 2nd Floor New Orleans LA 70112 20 41 1 >=18 1 2 2 29962465 90071902THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lillis Rebecca A. 136 S. Roman Street, 2nd Floor New Orleans LA 70112 20 2I 1 none 1 2 2 29962465 90071902THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ruiz Marco A. 136 S. Roman Street, 2nd Floor New Orleans LA 70112 20 2I 1 none 1 2 2 29962465 90071902THE PHYSICIAN'S ALLIANCE CORP (TPAC) Yount Royce D. "2025 Gravier Street, Suite 60 New Orleans LA 70112 20 06 1 none 1 2 2 29957441 90084115L & B LABORATORIES INC 1010 Common Street Ste 2010 New Orleans LA 70112 40 54 1 none 1 2 2 29953787 90073508THE PHYSICIAN'S ALLIANCE CORP (TPAC) Maffei Joanne T. 136 S. Roman Street 2nd Floor New Orleans LA 70112 20 2I 1 none 1 2 2 29959832 90079863THE PHYSICIAN'S ALLIANCE CORP (TPAC) Murphy Mary J. 136 S. Roman Street 2nd Floor New Orleans LA 70112 20 41 1 >=18 1 2 2 29959832 90079863

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Awtrey, Jr Richard W. 136 South Romain Street New Orleans LA 70112 20 10 1 none 1 2 2 29959832 90079863

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reiss Gary 136 South Romain Street New Orleans LA 70112 20 10 1 none 1 2 1 29959832 90079863THE PHYSICIAN'S ALLIANCE CORP (TPAC) Caputto Salvador 136 South Roman Street New Orleans LA 70112 20 2H 1 none 1 2 2 29959832 90079863THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cosgriff Thomas M. 136 South Roman Street New Orleans LA 70112 20 2H 1 none 1 2 2 29959832 90079863THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jack Avanelle V. 136 South Roman Street New Orleans LA 70112 20 2K 1 none 1 2 2 29959832 90079863THE PHYSICIAN'S ALLIANCE CORP (TPAC) Seiler Milton W. 136 South Roman Street New Orleans LA 70112 20 2H 1 none 1 2 2 29959832 90079863THE PHYSICIAN'S ALLIANCE CORP (TPAC) Seiler, Jr Milton 136 South Roman Street New Orleans LA 70112 20 2H 1 none 1 2 2 29959832 90079863THE PHYSICIAN'S ALLIANCE CORP (TPAC) Shenava Rajesh 136 South Roman Street New Orleans LA 70112 20 2K 1 none 1 2 2 29959832 90079863TULANE UNIVERSITY HOSPITAL AND CLINIC 1415 Tulane Avenue New Orleans LA 70112 60 86 1 none 1 1 1 29955436 90076153THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cefalu William T. 1450 Poydras Street New Orleans LA 70112 20 2E 1 none 1 2 2 29951411 90078191THE PHYSICIAN'S ALLIANCE CORP (TPAC) Culicchia Frank 1450 Poydras Street New Orleans LA 70112 20 14 1 none 1 2 2 29951411 90078191Ochsner Clinic Dawson Robert C. PT 1450 Poydras Street New Orleans LA 70112 20 30 1 none 1 2 1 29951411 90078191

Mclno-romain St Clinic

Mclno-romain St Clinic


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Steck John 1450 Poydras Street New Orleans LA 70112 20 13 1 none 1 2 2 29951411 90078191THE PHYSICIAN'S ALLIANCE CORP (TPAC) Steck John C. 1450 Poydras Street New Orleans LA 70112 20 14 1 none 1 2 2 29951411 90078191

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stuke Lance 1450 Poydras Street New Orleans LA 70112 20 02 1 none 1 2 2 29951411 90078191THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morse Stephen A. 146 S. Roman Street New Orleans LA 70112 19 2K 1 none 1 2 2 29959769 90079921THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ali Juzar 1532 Tulane Ave New Orleans LA 70112 20 29 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ali Juzar 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barker Benjamin 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Beck Robert 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bennett William 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Blackwell Evans 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Borne David M. 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chakraborti Chayan 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Clark Rebecca A. 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dennar Princess 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dicarlo Richard P. 1532 Tulane Ave New Orleans LA 70112 20 2I 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dicarlo Richard 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fotino Alina 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gillmore, III Jared 1532 Tulane Ave New Orleans LA 70112 20 33 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Glancy David 1532 Tulane Ave New Orleans LA 70112 20 33 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jain Neeraj 1532 Tulane Ave New Orleans LA 70112 20 06 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kamboj Sanjau 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kamboj Sanjay 1532 Tulane Ave New Orleans LA 70112 20 03 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lo Betty 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lopez Alfredo A. 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Martinez Jorge A 1532 Tulane Ave New Orleans LA 70112 20 1T 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Martinez Jorge 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mason Carol M. 1532 Tulane Ave New Orleans LA 70112 20 29 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mason Carol 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcdermott Diana T. 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724VAN METER MD & ASSOC AMC McKay Melissa MD 1532 Tulane Ave New Orleans LA 70112 20 1T 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Miller Chad 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mohan Maria 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Narula Tathgat 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Niyogi Anjali 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ory Bridget 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Price Anne 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Russo Emilio 1532 Tulane Ave New Orleans LA 70112 20 08 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sanders Charles V. 1532 Tulane Ave New Orleans LA 70112 20 2I 1 none 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sanders, Jr. Charles 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Spruill David 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thien Paul 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wallis John B. 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wiese Jeff 1532 Tulane Ave New Orleans LA 70112 20 41 1 >=18 1 2 2 29955728 90077724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Celebi Murat M. 1542 Tulane Avenue Box T3m-3 New Orleans LA 70112 20 06 1 none 1 2 2 29955874 90078042THE PHYSICIAN'S ALLIANCE CORP (TPAC) Eubanks Robert L. 1545 Tulane Avenue 2nd Floor New Orleans LA 70112 20 41 1 >=18 1 2 2 29956244 90077906THE PHYSICIAN'S ALLIANCE CORP (TPAC) Helmcke Frederick R. 1661 Canal Street Suite # 1200 New Orleans LA 70112 20 06 1 none 1 2 2 29959108 90077374THE PHYSICIAN'S ALLIANCE CORP (TPAC) Happel Kyle I. 1901 Perdido Street Box P3-5 New Orleans LA 70112 20 29 1 none 1 2 2 29955290 90082781THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dicarlo Richard P. 2020 Gravier Street 7th Floor New Orleans LA 70112 20 2I 1 none 1 2 2 29957182 90084227THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dicarlo Richard 2020 Gravier Street 7th Floor New Orleans LA 70112 20 41 1 >=18 1 2 2 29957182 90084227

Lsuhn Lord & Taylor Clinic


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hull Anne E. 2021 Perdido St New Orleans LA 70112 20 2I 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hull Anne 2021 Perdido St New Orleans LA 70112 20 41 1 >=18 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lin Tara 2021 Perdido St New Orleans LA 70112 20 2H 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) 2021 Perdido Street New Orleans LA 70112 20 05 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) 2021 Perdido Street New Orleans LA 70112 65 22 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) 2021 Perdido Street New Orleans LA 70112 20 30 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ali Murtuza 2021 Perdido Street New Orleans LA 70112 20 06 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Baker Christopher C. 2021 Perdido Street New Orleans LA 70112 20 02 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bell Donald P. 2021 Perdido Street New Orleans LA 70112 20 34 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Deboisblanc Bennett P. 2021 Perdido Street New Orleans LA 70112 20 29 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Delabretonne Gaston 2021 Perdido Street New Orleans LA 70112 20 07 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Diamond Karen A. 2021 Perdido Street New Orleans LA 70112 20 10 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Engel Lee S. 2021 Perdido Street New Orleans LA 70112 20 2I 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Falco Viviana C. 2021 Perdido Street New Orleans LA 70112 20 06 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ferrante William A. 2021 Perdido Street New Orleans LA 70112 20 10 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ghafar Mohamed 2021 Perdido Street New Orleans LA 70112 20 16 1 >=16 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Glynn Gary R. 2021 Perdido Street New Orleans LA 70112 35 65 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Greene Stacey 2021 Perdido Street New Orleans LA 70112 20 2I 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hunt John P. 2021 Perdido Street New Orleans LA 70112 20 02 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Janssen Pamela Ann 2021 Perdido Street New Orleans LA 70112 35 65 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kaye Alan D. 2021 Perdido Street New Orleans LA 70112 20 05 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Landrieu Keri 2021 Perdido Street New Orleans LA 70112 37 74 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Maffei Joanne T. 2021 Perdido Street New Orleans LA 70112 20 2I 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Marr Alan B. 2021 Perdido Street New Orleans LA 70112 20 02 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Martinez Jorge A 2021 Perdido Street New Orleans LA 70112 20 1T 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Martinez Jorge 2021 Perdido Street New Orleans LA 70112 20 41 1 >=18 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nguyen Thanh M. 2021 Perdido Street New Orleans LA 70112 20 06 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Quintal-Aviles Roberto E 2021 Perdido Street New Orleans LA 70112 20 06 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reddy Sanjeeva T. 2021 Perdido Street New Orleans LA 70112 20 10 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rigby Perry G. 2021 Perdido Street New Orleans LA 70112 20 2H 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rigby Perry 2021 Perdido Street New Orleans LA 70112 20 41 1 >=18 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Riopelle James M. 2021 Perdido Street New Orleans LA 70112 20 05 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ruiz-calderon Bernardo A. 2021 Perdido Street New Orleans LA 70112 65 22 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sanders Charles V. 2021 Perdido Street New Orleans LA 70112 20 2I 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sanders, Jr. Charles 2021 Perdido Street New Orleans LA 70112 20 41 1 >=18 1 2 2 29956287 90085036Ochsner Clinic St. Germain Gina M. 2021 Perdido Street New Orleans LA 70112 91 05 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Steeb Glen D. 2021 Perdido Street New Orleans LA 70112 20 02 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Welsh David A. 2021 Perdido Street New Orleans LA 70112 20 29 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wilcox Ronald 2021 Perdido Street New Orleans LA 70112 20 2I 1 none 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wilcox Ronald D. 2021 Perdido Street New Orleans LA 70112 20 41 1 >=18 1 2 2 29956287 90085036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hart Jennifer N. 2025 Gravier St Third Floor New Orleans LA 70112 20 41 1 >=18 1 2 2 29957441 90084115THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brewer Martha J 2100 Perdido Street New Orleans LA 70112 20 16 1 >=16 1 2 2 29956412 90086022THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stutes Michelle R. 2100 Perdido Street New Orleans LA 70112 20 16 1 >=16 1 2 2 29956412 90086022THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hollier Larry H. 433 Bolivar Street Suite 815 New Orleans LA 70112 20 2P 1 none 1 2 2 29957728 90083037THE PHYSICIAN'S ALLIANCE CORP (TPAC) Taylor Stephanie N. 517 N Rampart Street New Orleans LA 70112 20 2I 1 none 1 2 2 29959201 90069886NOHD HEALTHCARE FOR THE HOMELESS Preston Ione H. NP 2222 Simon Bolivar New Orleans LA 70113 20 41 1 =>18 1 2 2 29938726 90085267NOHD HEALTHCARE FOR THE HOMELESS Berrien Roberta MD 2222 Simon Bolivar Ave New Orleans LA 70113 20 41 1 =>18 1 2 2 29938726 90085267Kelly Spears Inc Spears Kristen Kelly MS 547 Baronne St Apt 402 New Orleans LA 70113 39 71 1 <=21 1 1 2 29949508 90073430Kelly Spears Inc. Spears Kristen Kelly 547 Baronne St. Apt. 402 New Orleans LA 70113 29 71 1 none 1 2 2 29949508 90073430THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tillery Bertrand 3500 Berhman Place Suite 200 New Olreans LA 70114 20 08 1 None 1 2 1 29918386 90017028


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

KENNEDY STACEY D OD Kennedy Stacey D. OD 3220 General DeGaulle Dr. #100 New Orleans LA 70114 28 88 1 none 1 2 2 29926710 90024297Ochsner Clinic Reddy Sadda R. 3401 Behrman Place New Orleans LA 70114 20 41 1 >=18 1 2 2 29919483 90017720Ochsner Clinic Robinson Wanda M. PT 3401 Behrman Place New Orleans LA 70114 20 08 1 None 1 2 2 29919483 90017720EDWARD L DONALDSON DDS AND JILL DONALDSON DDS 3501 BEHRMAN PLACE SUITE C NEW ORLEANS LA 70114 32 48 1 none 1 1 2 29918166 90017766MERIDIAN HEALTHCARE SERVICES LLC 3737 General De Gaulle Dr New Orleans LA 70114 29 71 1 none 1 2 2 29922784 90018412HOGUE HOGUE AND ROUHANA 4001 MACARTHUR BOULEVARD NEW ORLEANS LA 70114 32 48 1 none 1 1 2 29924304 90015115THE PHYSICIAN'S ALLIANCE CORP (TPAC) Seiler Milton 3525 Prytania St Ste 302 New Olreans LA 70115 20 2H 1 none 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wang Alun 3715 Prytania Street Suite 306 New Olreans LA 70115 20 22 1 none 1 2 1 29925871 90094656Ochsner Clinic Moises James P. 2700 Napoleon Ave. New Orleans LA 70115 20 1T 1 none 1 2 2 29937317 90103451PARISH ANESTHESIA OF NEW ORLEANS Age Verna Sherman CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Arcario Jane Ann CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Armand Troy Anthony CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Austin Michelle M. CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Bachireddy Arpana Reddy CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Bellow Karen Ann CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Benner Kevin Scott CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Benner Regina Fracchia CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Bork Toni Annette CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Boyd Christie Dedon CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Branting Scott Brian MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Brouillette Charlene V. CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Callaway Lauren M. CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Carter Don Emile CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Churi Sajay Bharat MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Cook Louise Segura CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Corn Michelle R. CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Denny Terri CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Desikacharlu Ananth MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Ellis-Hughes Vicky G. CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Faessler Charlotte J. CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Freeman James Carlton MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Galliano Dante Juan MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Gaudet Alyssa Blanchar CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Gernhauser Denise Stoufflet CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Glennis Jones Lyndia Maelene MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Gremillion Patricia Haskins CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Guarisco Kristen Kelly CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Gullage Troy James CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Hargis Monica CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Harris, Jr. George M. MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Henderson Crystal Sanders CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Hude Candice B. CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Jin John Yi-Zhou MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Kalil David Michael CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS King Denise Ruth CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Lagarde Judy Willis CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Lambert Candis Lynn CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Landreneau Nason Eric CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Landry Carol Anne CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS LeBlanc John Dunn CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

PARISH ANESTHESIA OF NEW ORLEANS Leggio Christy Maria CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Levin Louis W. MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Lombardi Nicole Angelle CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Marcell Bryan F. CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Martin Lisa Crosby CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS McKenzie Gena Marie CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Meekin Dawn Manley CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Monroe Karen Fray CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Morris, III Hershel Fisk CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Mustin, III Harold Stevenson CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Nobles Charles Houston CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS O'Blanc Nicole Bruno CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS O'Brien Mary Ellen CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Okungbowa Roland O. CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Olson Jeanette A. CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS O'Neill Rosalinda Garcia CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Paul Akkara Jose MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Pinkozie Dennis Phillips CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Powell Cynthia Orgeron CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Powell Michael Shane CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Roevens Kathleen Hymel CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Rosinia Francis Anthony MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Serbin Vonni Gay MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Shows Scott Thomas MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Simon Debra Ann CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Superchi Nicolet Genevieve CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 1 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Tortorich Frank CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Williams David James CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Williams Lynda Ann CRNA 1401 Foucher Street New Orleans LA 70115 91 05 1 none 1 2 2 29925021 90092611PARISH ANESTHESIA OF NEW ORLEANS Williams Rodrek Emilio MD 1401 Foucher Street New Orleans LA 70115 20 05 1 none 1 2 1 29925021 90092611NEW ORLEANS SPEECH AND HEARING CENTER 1636 Toledano St New Orleans LA 70115 39 71 1 none 1 2 1 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Benedic Melody 1636 Toledano St New Orleans LA 70115 34 64 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Brewer Ashley M. 1636 Toledano St New Orleans LA 70115 34 64 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Brown Lesley Gattuso 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Fitzgerald Callie 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Friedman Susan 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Gladney Lynda 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Hart Ellen 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Huete Whitney D. 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Jernigan Lesley 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Lay Rachel 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Schroeder Mae Fern 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Stouder Susan 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Tortorich Julie C. 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628NEW ORLEANS SPEECH AND HEARING CENTER Van Wart Louise 1636 Toledano St New Orleans LA 70115 29 71 1 none 1 2 2 29929059 90090628RESTORATIVE PROSTHETICS & ORT 2613 Napoleon Ave New Orleans LA 70115 40 54 1 none 1 2 2 29936466 90102802THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lama Anthony 2620 Jena Street 2nd Floor New Orleans LA 70115 20 2K 1 none 1 2 2 29936321 90104477THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lang Edward 2626 Jena Street New Orleans LA 70115 32 48 1 none 1 2 2 29936342 90104479THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bhansali Siddharth 2633 Napoleon Ave Ste 500 New Orleans LA 70115 20 06 1 none 1 2 2 29936593 90102815THE PHYSICIAN'S ALLIANCE CORP (TPAC) Faust Donald 2633 Napoleon Ave Ste 600 New Orleans LA 70115 20 24 1 none 1 2 1 29936593 90102815


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guider Benjamin A. 2633 Napoleon Ave Suite 705 New Orleans LA 70115 20 10 1 none 1 2 2 29936593 90102815THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kjellgren Olle 2633 Napoleon Ave Ste 500 New Orleans LA 70115 20 06 1 none 1 2 2 29936593 90102815THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mayer Herbert 2633 Napoleon Ave Suite 705 New Orleans LA 70115 20 10 1 none 1 2 2 29936593 90102815THE PHYSICIAN'S ALLIANCE CORP (TPAC) Price Steve F. 2633 Napoleon Ave Suite 705 New Orleans LA 70115 20 10 1 none 1 2 2 29936593 90102815THE PHYSICIAN'S ALLIANCE CORP (TPAC) St Martin Edward 2633 Napoleon Ave Ste 500 New Orleans LA 70115 20 06 1 none 1 2 2 29936593 90102815DRS. ST MARTIN, BHANSALI, KJELLGREN Bhansali Siddharth 2633 Napoleon Ave., #500 New Orleans LA 70115 20 06 1 none 1 2 2 29936593 90102815DRS. ST MARTIN, BHANSALI, KJELLGREN Kjellgren Olle 2633 Napoleon Ave., #500 New Orleans LA 70115 20 06 1 none 1 2 2 29936593 90102815DRS. ST MARTIN, BHANSALI, KJELLGREN St Martin Edward 2633 Napoleon Ave., #500 New Orleans LA 70115 20 06 1 none 1 2 2 29936593 90102815THE PHYSICIAN'S ALLIANCE CORP (TPAC) Davis Virginia 2633 Napoleon Avenue Suite 615 New Orleans LA 70115 35 65 1 none 1 2 2 29936593 90102815THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kirsch Arthur 2633 Napoleon Avenue Suite 615 New Orleans LA 70115 35 65 1 none 1 2 2 29936593 90102815Ochsner Baptist Medical Center 2700 Napolean Ave New Orleans LA 70115 60 86 1 none 1 2 2 29937317 90103451Ochsner Clinic Belleville Francine 2700 Napoleon Ave. New Orleans LA 70115 20 30 1 none 1 2 2 29937317 90103451Ochsner Clinic Broussard Erica M. 2700 Napoleon Ave. New Orleans LA 70115 20 30 1 none 1 2 2 29937317 90103451Ochsner Clinic Collins Jared F. 2700 Napoleon Ave. New Orleans LA 70115 20 41 1 >=18 1 2 2 29937317 90103451Ochsner Clinic Cresswell, III Lawrence H. 2700 Napoleon Ave. New Orleans LA 70115 19 1T 1 none 1 2 2 29937317 90103451Ochsner Clinic David, III W. Edward PT 2700 Napoleon Ave. New Orleans LA 70115 20 03 1 none 1 2 2 29937317 90103451Ochsner Clinic DeRosales Ana Belen R. 2700 Napoleon Ave. New Orleans LA 70115 20 41 1 >=18 1 2 2 29937317 90103451Ochsner Clinic Dowling Adam M. 2700 Napoleon Ave. New Orleans LA 70115 20 30 1 none 1 2 2 29937317 90103451Ochsner Clinic Dupin Charles L. 2700 Napoleon Ave. New Orleans LA 70115 20 02 1 none 1 2 2 29937317 90103451Ochsner Clinic Emerson Noah A. 2700 Napoleon Ave. New Orleans LA 70115 20 30 1 none 1 2 1 29937317 90103451Ochsner Clinic Eustis, Jr. H. Sprague 2700 Napoleon Ave. New Orleans LA 70115 20 18 1 none 1 2 1 29937317 90103451Ochsner Clinic Fraser Austin M. 2700 Napoleon Ave. New Orleans LA 70115 20 41 1 >=18 1 2 2 29937317 90103451Ochsner Clinic Hauver, II Terence L. 2700 Napoleon Ave. New Orleans LA 70115 20 1T 1 none 1 2 2 29937317 90103451Ochsner Clinic Huff Shelley R. 2700 Napoleon Ave. New Orleans LA 70115 28 88 1 none 1 2 2 29937317 90103451Ochsner Clinic Kirsh David S. 2700 Napoleon Ave. New Orleans LA 70115 20 30 1 none 1 2 2 29937317 90103451Ochsner Clinic Kolinsky Michael A. 2700 Napoleon Ave. New Orleans LA 70115 20 1T 1 none 1 2 2 29937317 90103451Ochsner Clinic Kumbala Damodar R. 2700 Napoleon Ave. New Orleans LA 70115 20 41 1 >=18 1 2 2 29937317 90103451Ochsner Clinic Liokis Evangelos A. 2700 Napoleon Ave. New Orleans LA 70115 20 30 1 none 1 2 2 29937317 90103451Ochsner Clinic Montelibano Lawrence E. 2700 Napoleon Ave. New Orleans LA 70115 20 03 1 none 1 2 2 29937317 90103451Ochsner Clinic Safavi Kurosh A. 2700 Napoleon Ave. New Orleans LA 70115 20 30 1 none 1 2 1 29937317 90103451Ochsner Clinic St. Hilaire Hugo 2700 Napoleon Ave. New Orleans LA 70115 20 24 1 none 1 2 1 29937317 90103451Ochsner Clinic Vinroot Richard A. 2700 Napoleon Ave. New Orleans LA 70115 20 1T 1 none 1 2 2 29937317 90103451Ochsner Clinic Wise M. Whitten 2700 Napoleon Ave. New Orleans LA 70115 20 24 1 none 1 2 2 29937317 90103451Ochsner Clinic Zaheri Kamran 2700 Napoleon Ave. New Orleans LA 70115 20 1T 1 none 1 2 1 29937317 90103451FLEUR DE LIS COMMUNITY HEALTH OB GYN Jeanfreau Susan G. MD 2820 Napolean Ave Ste 340 New Orleans LA 70115 20 16 1 >=16 1 2 2 29938394 90103553FLEUR DE LIS COMMUNITY HEALTH OB GYN 2820 Napoleon Ave Ste 340 New Orleans LA 70115 20 16 1 >=16 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cuchavovich Raquel 2820 Napoleon Ave Ste 890 New Orleans LA 70115 20 2M 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fuselier, Jr. Harold A. 2820 Napoleon Ave Suite 700 New Orleans LA 70115 20 34 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nguyen Lan Thi 2820 Napoleon Ave Suite 700 New Orleans LA 70115 20 16 1 >=16 1 2 2 29938394 90103553FLEUR DE LIS COMMUNITY HEALTH OB GYN Ryan Thomas B. MD 2820 Napoleon Ave Ste 340 New Orleans LA 70115 20 16 1 >=16 1 2 1 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Spiller Catherine C. 2820 Napoleon Ave Suite 890 New Orleans LA 70115 20 34 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tejedor Richard J. 2820 Napoleon Ave Suite 890 New Orleans LA 70115 20 29 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wallis John 2820 Napoleon Ave Suite 890 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wey Jane 2820 Napoleon Ave Suite 700 New Orleans LA 70115 20 02 1 none 1 2 2 29938394 90103553Ochsner Clinic Anthony Lowell B. 2820 Napoleon Ave. New Orleans LA 70115 20 2H 1 none 1 2 2 29938394 90103553Ochsner Clinic Boulmay Brian C. 2820 Napoleon Ave. New Orleans LA 70115 20 2H 1 none 1 2 2 29938394 90103553Ochsner Clinic Shah Pulin A. 2820 Napoleon Ave. MOB - Suite 370 New Orleans LA 70115 20 18 1 none 1 2 2 29938394 90103553Ochsner Clinic Tamma Srikanth 2820 Napoleon Ave. New Orleans LA 70115 20 2H 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Alleyn Jaime J. 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 16 1 >=16 1 2 2 29938394 90103553DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Alleyn James 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 16 1 >=16 1 2 1 29938394 90103553


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Amoss John R. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bagert Bridget A. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barnhill Danny R. 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 16 1 >=16 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barnhill Marianne 2820 Napoleon Avenue Suite #700 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barton Caroline L. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barton Lasandra M. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 29 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Borne David M. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bouligny Randy P. 2820 Napoleon Avenue Suite 750 New Orleans LA 70115 20 18 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) England John D. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Erny Eirinn E. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Espinoza Luis R. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 2M 1 none 1 2 2 29938394 90103553Ochsner Clinic Fondas Anne L. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fontenot Cathi E. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Foundas Anne L. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gee Rebekah 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 16 1 >=16 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gould Harry J. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gutierrez Amparo 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Helm Edward G. 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 02 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Holman Stacey L. 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 16 1 >=16 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kline David G. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 14 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lasperches Catherine 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 78 08 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leblanc Kim E. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 08 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lovera Jesus F. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mader Edward C. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mason Carol M. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 29 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mason Carol 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) McBurney Elizabeth I. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 07 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcdermott Diana T. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mclean Angela M. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Muncie Herbert L. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 08 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nelson Steve 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 29 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Olejniczak Piotr W. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Raines Daniel L. 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 10 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ramsey Jennifer 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 29 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reisin Efrain 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 2K 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) St. Hilaire Hugo 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 24 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Subramaniam Pramilla N. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 06 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Summer Warren R. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 29 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sumner Austin J. 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 13 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tender Gabriel 2820 Napoleon Avenue Suite 400 New Orleans LA 70115 20 14 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thomas Dwayne 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 29 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Velu Priya P. 2820 Napoleon Avenue Suite 890 New Orleans LA 70115 20 08 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Winfield Felton 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 16 1 >=16 1 2 2 29938394 90103553Ochsner Clinic Wise M. Whitten 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 24 1 none 1 2 2 29938394 90103553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wise Matthew W. 2820 Napoleon Avenue Suite 700 New Orleans LA 70115 20 24 1 none 1 2 2 29938394 90103553Quest Diagnostics 2820 Napoleon Avenue Suite 230 New Orleans LA 70115 20 30 1 none 1 1 2 29938394 90103553Ochsner Clinic Elizardi David J. 3423 St. Charles Ave. New Orleans LA 70115 20 06 1 none 1 2 2 29928288 90091954Ochsner Clinic Langenfels Lora M. 3423 St. Charles Ave. New Orleans LA 70115 20 08 1 None 1 2 2 29928288 90091954Ochsner Clinic McQueen, Jr. W. Richard 3423 St. Charles Ave. New Orleans LA 70115 20 41 1 >=18 1 2 2 29928288 90091954THE PHYSICIAN'S ALLIANCE CORP (TPAC) Estrada Lance 3434 Prytania St Suite 430 New Orleans LA 70115 20 20 1 none 1 2 2 29926442 90091619


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Laborde James M. 3434 Prytania St Sutie 430 New Orleans LA 70115 20 20 1 none 1 2 2 29926442 90091619THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lurie Douglas 3434 Prytania St Suite 430 New Orleans LA 70115 20 20 1 none 1 2 2 29926442 90091619THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meyer Richard 3434 Prytania St Suite 310 New Orleans LA 70115 20 20 1 none 1 2 2 29926442 90091619THE PHYSICIAN'S ALLIANCE CORP (TPAC) Watson Kevin 3434 Prytania St Suite 430 New Orleans LA 70115 20 20 1 none 1 2 2 29926442 90091619NEW ORLEANS EYE SPECIALISTS Balkan Robert J. MD 3434 Prytania St Suite 250 New Orleans LA 70115 20 18 1 none 1 2 1 29926442 90091619ORTHOPAEDIC ASSOCIATES OF NEW ORLEANS, APMC Estrada Lance 3434 Prytania St. Suite 430 New Orleans LA 70115 20 20 1 none 1 2 2 29926442 90091619ORTHOPAEDIC ASSOCIATES OF NEW ORLEANS, APMC Laborde James M. 3434 Prytania St. Suite 430 New Orleans LA 70115 20 20 1 >=18 1 2 2 29926442 90091619ORTHOPAEDIC ASSOCIATES OF NEW ORLEANS, APMC Lurie, Jr. Douglas N. 3434 Prytania St. Suite 430 New Orleans LA 70115 20 20 1 none 1 2 2 29926442 90091619ORTHOPAEDIC ASSOCIATES OF NEW ORLEANS, APMC Watson Kevin M. MD 3434 Prytania St. Suite 430 New Orleans LA 70115 20 20 1 none 1 2 2 29926442 90091619NEW ORLEANS EYE SPECIALISTS Hendricks Clifford A. MD 3434 Prytania St. Suite 250 New Orleans LA 70115 20 18 1 none 1 2 2 29926442 90091619NEW ORLEANS EYE SPECIALISTS Leader Barry J. 3434 Prytania St. Suite 250 New Orleans LA 70115 20 18 1 none 1 2 2 29926442 90091619THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cruz Frank 3525 Prytania Suite 620 New Orleans LA 70115 20 2K 1 none 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boyd Bonnie 3525 Prytania St Ste 526 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Coco Jeffrey 3525 Prytania St Ste 526 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577GARY DANOS, MD Danos Gary J. MD 3525 Prytania St Ste 618 New Orleans LA 70115 20 02 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ernst, III John 3525 Prytania St Ste 430 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fischman Nathan 3525 Prytania St Suite 308 New Orleans LA 70115 20 34 1 none 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fox April 3525 Prytania St Suite 620 New Orleans LA 70115 20 2K 1 none 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Garg Om 3525 Prytania St Ste 321 New Orleans LA 70115 20 29 1 none 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Glade Leonard 3525 Prytania St Ste 526 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gonzalez Pedro L. 3525 Prytania St Ste 526 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson, III Harry 3525 Prytania St New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lowentritt Joshua 3525 Prytania St Ste 526 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lurie Jamie 3525 Prytania St Ste 526 New Orleans LA 70115 20 03 1 none 1 2 2 29926428 90092577IRA P MARKOWITZ, MD FACS Markowitz Ira P. MD 3525 Prytania St Ste 418 New Orleans LA 70115 20 2P 1 none 1 2 1 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcnally Mario 3525 Prytania St Ste 526 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mims, II Thomas H. 3525 Prytania St Ste 526 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pham Chung V. 3525 Prytania St Ste 526 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reginelli Angela 3525 Prytania St Ste 620 New Orleans LA 70115 20 2K 1 none 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rodriguez Eduardo 3525 Prytania St Ste 526 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith, III Charles C. 3525 Prytania St Ste 526 New Orleans LA 70115 20 41 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sullivan-Fraught Jan 3525 Prytania St Ste 526 New Orleans LA 70115 78 79 1 >=18 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Caputto Salvador 3525 Prytania St, Suite 302 New Orleans LA 70115 20 2H 1 none 1 2 2 29926428 90092577STEPHEN J DERBES, MD Derbes Stephen J. MD 3525 Prytania St., #321 New Orleans LA 70115 20 2M 1 none 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vichot Alfredo 3525 Prytania St., Ste 309 New Orleans LA 70115 20 2M 1 none 1 2 2 29926428 90092577ROBERT D ROSS MD APMC Ross Robert D. MD, FACS 3525 Prytania St., Ste. 430 New Orleans LA 70115 20 18 1 none 1 2 1 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Adinolfi Michael 3525 Prytania Street Suite 618 New Orleans LA 70115 20 2P 1 none 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cruz Francisco 3525 Prytania Street Suite 620 New Orleans LA 70115 20 2K 1 none 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Danos Gary 3525 Prytania Street Suite 618 New Orleans LA 70115 20 02 1 none 1 2 2 29926428 90092577Quest Diagnostics 3525 Prytania Street Suite 506 New Orleans LA 70115 20 30 1 none 1 1 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Baum Neil 3525 Prytania, Ste 614 New Orleans LA 70115 20 34 1 none 1 2 2 29926428 90092577THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wang Fikre S. 3600 Prytania Suite 65 New Orleans LA 70115 20 02 1 none 1 2 2 29925929 90093276THE PHYSICIAN'S ALLIANCE CORP (TPAC) Akula Shiva K. 3600 Prytania St Suite 65 New Orleans LA 70115 20 2I 1 none 1 2 1 29925929 90093276THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jawad Majid 3600 Prytania St Suite 65 New Orleans LA 70115 20 41 1 >=18 1 2 2 29925929 90093276OM GARG, MD Garg Om P. MD 3600 Prytania St. #65 New Orleans LA 70115 20 29 1 >=18 1 2 2 29925929 90093276WALKER GEORGE S MD Walker George Stanley MD 3600 Prytania Street Ste 76 New Orleans LA 70115 20 04 1 none 1 2 2 29925929 90093276LAMBERTS ORTHOTICS-PROSTHET PATIENT AIDS 3627 Magazine St New Orleans LA 70115 40 53 1 none 1 2 1 29922047 90092311BRYAN WASHINGTON MD Bryan, Sr. Washington M.D. 3720 Prytania Street New Orleans LA 70115 20 16 1 none 1 2 1 29925600 90094603FYEO LLC DBA FOR YOUR EYES ONLY 20/20 Richardson Daphne OD 4220 Amagazine St New Orleans LA 70115 28 88 1 none 1 2 1 29923678 90097235THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcsherry Susan 4429 Clara St Ste 600 New Orleans LA 70115 20 34 1 none 1 2 2 29938227 90103787


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Bagert Bridget A. 4429 Clara St. Suite 440 New Orleans LA 70115 20 13 1 none 1 2 2 29938227 90103787Ochsner Clinic Farris, Jr. Charles 4429 Clara St. Suite 400 New Orleans LA 70115 20 16 1 >=16 1 2 2 29938227 90103787Ochsner Clinic Blessey Karen B. 4429 Clara St. Suite 500 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938227 90103787Ochsner Clinic Eissa Hazem E. 4429 Clara St. Suite 540 New Orleans LA 70115 35 65 1 none 1 2 2 29938227 90103787Ochsner Clinic Gillispie Veronica G. 4429 Clara St. Suite 400 New Orleans LA 70115 20 16 1 >=16 1 2 1 29938227 90103787Ochsner Clinic Jancich Sophy A. 4429 Clara St. Suite 500 New Orleans LA 70115 20 2H 1 none 1 2 2 29938227 90103787Ochsner Clinic Khan Muhammad Ali 4429 Clara St. Suite 540 New Orleans LA 70115 20 05 1 none 1 2 2 29938227 90103787Ochsner Clinic Lapeyre Elizabeth 4429 Clara St. Suite 400 New Orleans LA 70115 20 16 1 >=16 1 2 1 29938227 90103787Ochsner Clinic Miles, Jr. Robert H. 4429 Clara St. Suite 500 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938227 90103787Ochsner Clinic Pelitere Margaret M. 4429 Clara St. Suite 500 New Orleans LA 70115 20 41 1 >=18 1 2 2 29938227 90103787Ochsner Clinic Ramsay R. Eugene 4429 Clara St. Suite 440 New Orleans LA 70115 20 13 1 none 1 2 2 29938227 90103787Ochsner Clinic Redillas Carol R. 4429 Clara St. Suite 440 New Orleans LA 70115 20 13 1 none 1 2 2 29938227 90103787Ochsner Clinic Roberie Margaret A. 4429 Clara St. Suite 400 New Orleans LA 70115 20 16 1 >=16 1 2 1 29938227 90103787Ochsner Clinic Royster Eric I. 4429 Clara St. Suite 540 New Orleans LA 70115 20 05 1 none 1 2 2 29938227 90103787Ochsner Clinic Sargent William T. 4429 Clara St. Suite 400 New Orleans LA 70115 20 16 1 >=16 1 2 1 29938227 90103787Ochsner Clinic White Anna M. 4429 Clara St. Suite 400 New Orleans LA 70115 20 16 1 >=16 1 2 2 29938227 90103787Ochsner Clinic Wormuth Christopher J. 4429 Clara St. Suite 500 New Orleans LA 70115 20 08 1 None 1 2 2 29938227 90103787UNITED MEDICAL PROVIDERS INC 4826 Magazine Street New Orleans LA 70115 40 54 1 none 1 2 1 29920236 90106779THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leggio Christopher 4926 Magazine St New Orleans LA 70115 32 48 1 none 1 2 1 29920164 90108494KORCZ MICHELLE D OD Korcz Michelle OD 5300 Freret Street New Orleans LA 70115 28 88 1 none 1 2 2 29934987 90110762THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bodet Colleen F. 5625 Loyola Avneue New Orleans LA 70115 78 08 1 none 1 2 2 29936473 90112011GALVEZ DOCTORS CLINIC 1407 Piety Street New Orleans LA 70117 20 16 1 >=16 1 2 2 29970194 90040480GALVEZ DOCTORS CLINIC Davis Anna C. MD 1407 Piety Street New Orleans LA 70117 20 41 1 >=18 1 2 2 29970194 90040480GALVEZ DOCTORS CLINIC Raj Shailaja 1407 Piety Street New Orleans LA 70117 20 16 1 >=16 1 2 2 29970194 90040480GALVEZ DOCTORS CLINIC Wiley Kenneth L. MD 1407 Piety Street New Orleans LA 70117 20 41 1 >=18 1 2 1 29970194 90040480TUHC PHYSICIAN GROUP, LLC CUMMINGS Terry MD 200 Broadway Suite 230 New Orleans LA 70118 20 41 1 none 1 1 2 29929882 90132898THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hackett Judith 1901 Leonidas Street New Orleans LA 70118 20 08 1 None 1 2 1 29955719 90128451THE PHYSICIAN'S ALLIANCE CORP (TPAC) Velez-Yanguas Maria 200 Henry Clay New Orleans LA 70118 20 2H 1 none 1 2 2 29917445 90127258THE PHYSICIAN'S ALLIANCE CORP (TPAC) Velez-Yanguas Maria 200 Henry Clay New Orleans LA 70118 20 37 1 <=18 1 2 2 29917445 90127258THE PHYSICIAN'S ALLIANCE CORP (TPAC) Paris Kenneth 200 Henry Clay Ave. New Orleans LA 70118 20 03 1 none 1 2 2 29917445 90127258Hanger Prosthetics & Orthotics Inc. 200 Henry Clay Avenue Childrens Hospital New Orleans LA 70118 40 53 1 none 1 1 2 29917445 90127258THE PHYSICIAN'S ALLIANCE CORP (TPAC) English Marcia R. 200 Henry Clay Avenue New Orleans LA 70118 20 37 1 <=18 1 2 2 29917445 90127258THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morales-Arias Jaime A. 200 Henry Clay Avenue New Orleans LA 70118 20 2H 1 none 1 2 2 29917445 90127258HANGER PROSTHETICS AND ORTHOTICS 200 Henry Clay St New Orleans LA 70118 40 53 1 none 1 2 1 29917445 90127258DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS 3201 S. Carrollton Ave New Orleans LA 70118 72 9L 1 none 1 2 2 29961651 90114018DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Alleyn James 3201 S. Carrollton Ave New Orleans LA 70118 20 16 1 >=16 1 2 1 29961651 90114018DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Bevrotte Louis 3201 S. Carrollton Ave New Orleans LA 70118 20 37 1 <=18 1 2 1 29961651 90114018DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Bouchette Daniel 3201 S. Carrollton Ave New Orleans LA 70118 20 08 1 None 1 2 1 29961651 90114018DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Centanni EvaBlanche 3201 S. Carrollton Ave New Orleans LA 70118 20 08 1 none 1 2 2 29961651 90114018DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Donaldson-Bailey Michelle 3201 S. Carrollton Ave New Orleans LA 70118 20 48 1 none 1 2 2 29961651 90114018DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Post Robert 3201 S. Carrollton Ave New Orleans LA 70118 20 08 1 None 1 2 1 29961651 90114018DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Raman Radha 3201 S. Carrollton Ave New Orleans LA 70118 20 08 1 None 1 2 2 29961651 90114018DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Tennyson Margaret 3201 S. Carrollton Ave New Orleans LA 70118 90 16 1 >=16 1 2 2 29961651 90114018DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Urbizo Carolina 3201 S. Carrollton Ave New Orleans LA 70118 20 08 1 none 1 2 2 29961651 90114018DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Woodall-Ruff Denise 3201 S. Carrollton Ave New Orleans LA 70118 20 08 1 none 1 2 2 29961651 90114018THE PHYSICIAN'S ALLIANCE CORP (TPAC) Macaluso Anthony 714 Dublin Street New Orleans LA 70118 35 65 1 none 1 2 2 29944972 90134311THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lousteau Ray J. 120 N Jefferson David Pkwy New Orleans LA 70119 20 04 1 none 1 2 2 29970063 90093516THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cecola Russell P. 120 N Jefferson Davis Pkwy New Orleans LA 70119 20 04 1 none 1 2 1 29970063 90093516PRIMARY EYE CARE Johnson Jarrett Ann 1530 N. Broad Street New Orleans LA 70119 28 88 1 none 1 2 1 29978131 90076067NO / AIDS TASK FORCE Campusano Socrates Z. 2601 Tulane Ave Suite 500 New Orleans LA 70119 35 65 1 none 1 2 2 29961321 90089070


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

NO / AIDS TASK FORCE Gootee Mary P. 2601 Tulane Ave Suite 500 New Orleans LA 70119 78 08 1 >=18 1 2 2 29961321 90089070NO / AIDS TASK FORCE Murphy Mary J. 2601 Tulane Ave Suite 500 New Orleans LA 70119 20 41 1 >=18 1 2 2 29961321 90089070NO / AIDS TASK FORCE Pindaro Carole M. 2601 Tulane Ave Suite 500 New Orleans LA 70119 78 08 1 >=18 1 2 2 29961321 90089070MICHAEL HUNTER Hunter Michael S. MD 2610 Esplanade Ave 2nd Floor, Ste B New Orleans LA 70119 20 08 1 None 1 2 2 29976128 90078687THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson Glenn 2820 Canal Street New Orleans LA 70119 20 06 1 none 1 2 2 29966546 90089216DIMITRI EYE CARE Dimitri George J. MD 3301 Canal St New Orleans LA 70119 20 18 1 none 1 2 1 29969573 90092814DIMITRI EYE CARE Prouet, Jr. Paul E. OD 3301 Canal St New Orleans LA 70119 20 18 1 none 1 2 1 29969573 90092814DIMITRI EYE CARE Dimitri Ronald OD 3301 Canal St. New Orleans LA 70119 28 88 1 none 1 2 2 29969573 90092814AUDIBEL HEARING HEALTHCARE 4640 S. Carrolton Ave New Orleans LA 70119 34 64 1 none 1 2 2 29973097 90101791Ochsner Clinic Breaux Robin 1221 Clearview Pkwy. Harahan LA 70121 29 71 1 none 1 2 2 29962275 90184234Ochsner Clinic Karl Ellen Forshag 1221 Clearview Pkwy. Harahan LA 70121 29 71 1 none 1 2 2 29962275 90184234MR WHEELCHAIR * 1201 Jefferson Hwy. Jefferson LA 70121 40 54 1 none 1 2 1 29962624 90142234LYNDON GRAVES PC 200 Jefferson Hwy Jefferson LA 70121 28 88 1 none 1 2 2 29964334 90132113JEFFERSON PARISH SBHC - BONNABEL SBHC Peterson Tina 240 Riverdale Dr Jefferson LA 70121 78 79 1 >=18 1 2 2 29958963 90165427JEFFERSON PARISH SBHC - BONNABEL SBHC Campbell James MD 240 Riverdale Dr. Jefferson LA 70121 20 37 1 <=18 1 2 2 29958963 90165427KJ MEDICAL LLC, DBA ALLSTAR MEDICAL EQUIPMENT 3430 Jefferson Hwy Suite A Jefferson LA 70121 40 54 1 none 1 2 2 29962926 90160382HANGER PROSTHETICS AND ORTHOTICS 3750 Jefferson Highway Jefferson LA 70121 40 53 1 none 1 2 1 29963046 90164856Ochsner Clinic Anand Kiran Kaur 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Bearelly Dilip 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Broussard David M. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Broussard Erica M. 1516 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962660 90145388Ochsner Clinic Cresswell, III Lawrence H. 1516 Jefferson Highway New Orleans LA 70121 19 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Donaldson Emilie E. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Eisele Christiane N. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 1 29962660 90145388Ochsner Clinic Falterman Jason B. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Fogarasi Simone R. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Forshag Ann S. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Fritz Bryan J. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Gonzalez Yolanda 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Hajjar Joseph D. 1516 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962660 90145388Ochsner Clinic Halat Shams K. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Harris, Jr. Eugene A. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Hauver, II Terence L. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Hawawini Fadi 1516 Jefferson Highway New Orleans LA 70121 19 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Hebert Vicky S. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Huang Li 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Hutchings Rebecca A. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 1 29962660 90145388Ochsner Clinic Jones Jim A. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Kitzman Geoffrey A. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Link Robert B. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Moody Andrew J. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Murray Rebecca A. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Occhipinti Elise A. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Ogden Brian A. 1516 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962660 90145388Ochsner Clinic Osteen Kristie D. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Ramee Emily J. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Ravipati Lakshmi NP 1516 Jefferson Highway New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Restrepo Robert 1516 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962660 90145388Ochsner Clinic Rupinderjit Dhillon S. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Safavi Kurosh A. 1516 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 1 29962660 90145388


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Schubert Armin 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Shoaf Flora B. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Sightler Harold E. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Soberon, Jr. Jose R. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Waterman Ruth S. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Babycos Christopher R. 1221 Clearview Parkway New Orleans LA 70121 20 24 1 none 1 2 2 29962275 90184234Ochsner Clinic Bukara Mirjana 1221 Clearview Parkway New Orleans LA 70121 35 65 1 >=18 1 2 2 29962275 90184234Ochsner Clinic Clisham P. Ronald 1221 Clearview Parkway New Orleans LA 70121 20 16 1 >=16 1 2 2 29962275 90184234Ochsner Clinic Goldman Barry C. 1221 Clearview Parkway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962275 90184234Ochsner Clinic Graham, III H. Devon 1221 Clearview Parkway New Orleans LA 70121 20 04 1 none 1 2 2 29962275 90184234Ochsner Clinic Jones Deryk G. 1221 Clearview Parkway New Orleans LA 70121 20 20 1 none 1 2 2 29962275 90184234Ochsner Clinic Keating Christine M. 1221 Clearview Parkway New Orleans LA 70121 35 65 1 none 1 2 2 29962275 90184234Ochsner Clinic McQueen Matthew A. 1221 Clearview Parkway New Orleans LA 70121 20 08 1 None 1 2 2 29962275 90184234Ochsner Clinic Montgomery Scott C. 1221 Clearview Parkway New Orleans LA 70121 20 20 1 none 1 2 2 29962275 90184234Ochsner Clinic Sarmini Mahmoud M. 1221 Clearview Parkway New Orleans LA 70121 35 65 1 none 1 2 2 29962275 90184234Ochsner Clinic Saucier Michael A. 1221 Clearview Parkway New Orleans LA 70121 35 65 1 none 1 2 2 29962275 90184234Ochsner Clinic Suri Misty 1221 Clearview Parkway New Orleans LA 70121 20 20 1 none 1 2 2 29962275 90184234Ochsner Clinic Bronfin Daniel R. 1315 Jefferson Highway New Orleans LA 70121 20 37 1 <=18 1 2 2 29962726 90142895Ochsner Clinic Brown Kefla G. 1315 Jefferson Highway New Orleans LA 70121 28 88 1 none 1 2 2 29962726 90142895Ochsner Clinic Fielkow Susan K. PT 1315 Jefferson Highway New Orleans LA 70121 20 37 1 <=18 1 2 2 29962726 90142895Ochsner Clinic Moreau Judy M. 1315 Jefferson Highway New Orleans LA 70121 19 37 1 <=18 1 2 1 29962726 90142895Ochsner Clinic Parkerson Jennifer M. PT 1315 Jefferson Highway New Orleans LA 70121 20 37 1 <=18 1 2 1 29962726 90142895Ochsner Clinic Reymond Renee F. 1315 Jefferson Highway New Orleans LA 70121 20 37 1 <=18 1 2 2 29962726 90142895Ochsner Clinic Shourbaji Naglaa A. 1315 Jefferson Highway New Orleans LA 70121 20 37 1 <=18 1 2 2 29962726 90142895Ochsner Clinic Steele Russell W. 1315 Jefferson Highway New Orleans LA 70121 20 2I 1 none 1 2 2 29962726 90142895Ochsner Clinic Steiner Rodney B. 1315 Jefferson Highway New Orleans LA 70121 20 1P 1 none 1 2 1 29962726 90142895Ochsner Clinic Willis, II John K. 1315 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 1 29962726 90142895Ochsner Clinic Adolph Vincent R. 1315 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 1 29962726 90142895Ochsner Clinic Cunningham Robert J. 1315 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962726 90142895Ochsner Clinic Ducos Rafael S. PT 1315 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962726 90142895Ochsner Clinic Guarisco J. Lindhe 1315 Jefferson Highway New Orleans LA 70121 20 04 1 none 1 2 1 29962726 90142895Ochsner Clinic Kantrow, III Charles M. 1315 Jefferson Highway New Orleans LA 70121 20 37 1 <=18 1 2 2 29962726 90142895Ochsner Clinic Lucas Jr. Victor W. 1315 Jefferson Highway New Orleans LA 70121 20 1D 1 none 1 2 1 29962726 90142895Ochsner Clinic Ortenberg Joseph PT 1315 Jefferson Highway New Orleans LA 70121 20 34 1 none 1 2 1 29962726 90142895Ochsner Clinic Snyder Christopher S. 1315 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 1 29962726 90142895Ochsner Clinic Warren Frederic H. 1315 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 1 29962726 90142895Ochsner Clinic White Michael G. 1315 Jefferson Highway New Orleans LA 70121 20 1D 1 none 1 2 1 29962726 90142895Ochsner Clinic Sanchez Abbey 1315 Jefferson Hwy. New Orleans LA 70121 29 71 1 none 1 2 2 29962726 90142895Ochsner Clinic Aleander Peggy A. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Andrepont Tanya 1514 Jefferson Hwy. New Orleans LA 70121 34 64 1 none 1 2 2 29962614 90145095Ochsner Clinic Bergeron Shannon 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Bird Jeremy 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Blazek Jamie D. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Bolton Margeret M. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Byars Mary 1514 Jefferson Hwy. New Orleans LA 70121 90 16 1 >=16 1 2 2 29962614 90145095Ochsner Clinic Casey-Coe Maureen 1514 Jefferson Hwy. New Orleans LA 70121 29 71 1 none 1 2 2 29962614 90145095Ochsner Clinic Champagne Verne A. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Des Bordes Maria 1514 Jefferson Hwy. New Orleans LA 70121 78 08 1 None 1 2 2 29962614 90145095Ochsner Clinic Drake Kimberly A. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Ducote Charlotte A. 1514 Jefferson Hwy. New Orleans LA 70121 29 71 1 none 1 2 2 29962614 90145095


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Duhon-Johnston Susan 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Duthu Stacie 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Eckhardt Lynn S. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Estapa Amanda 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Fabacher Michelle 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Farrington Sherry 1514 Jefferson Hwy. New Orleans LA 70121 78 08 1 None 1 2 2 29962614 90145095Ochsner Clinic Fincher Brandi 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Friend Erin 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Gauthier Debra A. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic George Gwendolyn 1514 Jefferson Hwy. New Orleans LA 70121 78 08 1 None 1 2 2 29962614 90145095Ochsner Clinic G'Sell Aimee J. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Hebert Ana Maria 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Hess Claire 1514 Jefferson Hwy. New Orleans LA 70121 34 64 1 none 1 2 2 29962614 90145095Ochsner Clinic Holland Cecilia L. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Howell Mary V. 1514 Jefferson Hwy. New Orleans LA 70121 78 16 1 >=16 1 2 2 29962614 90145095Ochsner Clinic Jarrell Cielena 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Klug Chad 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Lacaze Kristina S. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 1 29962614 90145095Ochsner Clinic Lanks Leesa 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Linn Amy 1514 Jefferson Hwy. New Orleans LA 70121 90 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Matranga Gerry 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Minet Roxanne 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Morgan Erin 1514 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962614 90145095Ochsner Clinic Nolan Alison B. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Nusloch Colleen M. 1514 Jefferson Hwy. New Orleans LA 70121 29 71 1 none 1 2 2 29962614 90145095Ochsner Clinic Palmisano Kimberly 1514 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962614 90145095Ochsner Clinic Peevy Yvette S. 1514 Jefferson Hwy. New Orleans LA 70121 29 71 1 none 1 2 2 29962614 90145095Ochsner Clinic Peirsol-Schipper Catherine 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Pennier Carsten 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Perkins Shannon 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Porter Sheri Wagner 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Power Charmaine 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Randall Cindy 1514 Jefferson Hwy. New Orleans LA 70121 34 64 1 none 1 2 2 29962614 90145095Ochsner Clinic Randolph Shalan M. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Redwantz Tara 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Richard Anita S. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Risey John 1514 Jefferson Hwy. New Orleans LA 70121 34 64 1 none 1 2 2 29962614 90145095Ochsner Clinic Rivera Donna 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Rome Robin 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Ryan Stephanie C. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Schexnayder Debra 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Spector Michelle 1514 Jefferson Hwy. New Orleans LA 70121 34 64 1 none 1 2 2 29962614 90145095Ochsner Clinic Story Colleen M. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Strecker Kristine 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Tannehill Carin C. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Theriot Debra H. 1514 Jefferson Hwy. New Orleans LA 70121 93 2P 1 none 1 2 1 29962614 90145095Ochsner Clinic Thibodeaux Brent K. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Trahan Pamela Y. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Traylor Jeanne S. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Whitfield Malinda M. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Williams Joseph E. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Woods Daneeka A. 1514 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Abbas Abbas E. 1514 Jefferson Highway New Orleans LA 70121 20 33 1 none 1 2 2 29962614 90145095Ochsner Clinic Abi-Samra Freddy M. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Africk Diane K. 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic Akingbola Aderonke F. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Al Hariri Adham B. 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 2 29962614 90145095Ochsner Clinic Alkadri Mohi E. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Amedee Ronald G. 1514 Jefferson Highway New Orleans LA 70121 20 04 1 none 1 2 2 29962614 90145095Ochsner Clinic Andrews Samuel S. 1514 Jefferson Highway New Orleans LA 70121 20 2E 1 none 1 2 2 29962614 90145095Ochsner Clinic Anthony Lowell B. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Antillon Mainor R. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Arend Laurence W. 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 2 29962614 90145095Ochsner Clinic Babycos Christopher R. 1514 Jefferson Highway New Orleans LA 70121 20 24 1 none 1 2 2 29962614 90145095Ochsner Clinic Badawi Ramy A. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Bagert Bridget A. 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic Bardot Stephen F. 1514 Jefferson Highway New Orleans LA 70121 20 34 1 none 1 2 2 29962614 90145095Ochsner Clinic Basha Mahdi M. 1514 Jefferson Highway New Orleans LA 70121 19 18 1 none 1 2 2 29962614 90145095Ochsner Clinic Bell Kenneth A. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Belleville Francine 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Bernal Jose Alberto 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Blais Christopher M. 1514 Jefferson Highway New Orleans LA 70121 20 2I 1 none 1 2 2 29962614 90145095Ochsner Clinic Blake Leslie A. PT 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Blemur, Jr. Pierre R. 1514 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962614 90145095Ochsner Clinic Blonde Lawrence 1514 Jefferson Highway New Orleans LA 70121 20 2E 1 none 1 2 2 29962614 90145095Ochsner Clinic Bluth Edward I. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Bodana Shirisha 1514 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962614 90145095Ochsner Clinic Bohl James L. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Bohorquez Humberto E. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Bolton John S. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Bonner Kirk L. 1514 Jefferson Highway New Orleans LA 70121 20 08 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Borchers Stephen M. 1514 Jefferson Highway New Orleans LA 70121 28 88 1 none 1 2 2 29962614 90145095Ochsner Clinic Borg Brian B. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Boudreaux Lionel E. 1514 Jefferson Highway New Orleans LA 70121 28 88 1 none 1 2 2 29962614 90145095Ochsner Clinic Boulmay Brian C. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Bowen John C. 1514 Jefferson Highway New Orleans LA 70121 20 2P 1 none 1 2 2 29962614 90145095Ochsner Clinic Bragg, Jr. James W. 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Breault Joseph L. 1514 Jefferson Highway New Orleans LA 70121 20 08 1 None 1 2 2 29962614 90145095Ochsner Clinic Breaux Patrick C. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Brown Kefla G. 1514 Jefferson Highway New Orleans LA 70121 28 88 1 none 1 2 2 29962614 90145095Ochsner Clinic Brown, Jr. Archibald W. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Bruce David S. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Bui Cuong J. 1514 Jefferson Highway New Orleans LA 70121 20 14 1 none 1 2 1 29962614 90145095Ochsner Clinic Burshell Alan L. 1514 Jefferson Highway New Orleans LA 70121 20 2E 1 none 1 2 2 29962614 90145095Ochsner Clinic Bustamante James E. 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Butcher, II R. Brent 1514 Jefferson Highway New Orleans LA 70121 20 04 1 none 1 2 2 29962614 90145095Ochsner Clinic Byrd, Jr. Kenneth J. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Camody Ian C. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Canzoneri Bernard J. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Chava Pavon 1514 Jefferson Highway New Orleans LA 70121 19 2E 1 none 1 2 2 29962614 90145095


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Chimento George F. 1514 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 2 29962614 90145095Ochsner Clinic Cohen Ari J. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Cole John T. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Colegrove Jeffery A. 1514 Jefferson Highway New Orleans LA 70121 28 88 1 none 1 2 2 29962614 90145095Ochsner Clinic Coleman William C. 1514 Jefferson Highway New Orleans LA 70121 32 48 1 none 1 2 2 29962614 90145095Ochsner Clinic Collins Tyrone J. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Connolly Sean E. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Conway, II W. Charles 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Corsetti Ralph L. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Cotterman Catherine A. 1514 Jefferson Highway New Orleans LA 70121 20 07 1 none 1 2 2 29962614 90145095Ochsner Clinic Cox R. Harold PT 1514 Jefferson Highway New Orleans LA 70121 20 04 1 none 1 2 2 29962614 90145095Ochsner Clinic Cruz Bedford Nieves 1514 Jefferson Highway New Orleans LA 70121 20 1C 1 none 1 2 1 29962614 90145095Ochsner Clinic Danna Julie G. 1514 Jefferson Highway New Orleans LA 70121 20 07 1 none 1 2 2 29962614 90145095Ochsner Clinic Dasgupta Anjali 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Davis William E. 1514 Jefferson Highway New Orleans LA 70121 20 2M 1 none 1 2 2 29962614 90145095Ochsner Clinic Dawson Robert C. PT 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 1 29962614 90145095Ochsner Clinic DeBoisblanc Bennett P. 1514 Jefferson Highway New Orleans LA 70121 20 29 1 none 1 2 2 29962614 90145095Ochsner Clinic DeGrange Christie V. 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Deichmann, Jr. Richard E. 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Delaney, Jr. Patrick A. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Desai Sapna V. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic DiGiovanni Neil M. 1514 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962614 90145095Ochsner Clinic Dinshaw Homeyar K. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Dipp Susana L. 1514 Jefferson Highway New Orleans LA 70121 20 2E 1 none 1 2 2 29962614 90145095Ochsner Clinic Dupin Charles L. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Elizardi David J. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Elkadi Ghassan H. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Elnaggar Mini J. 1514 Jefferson Highway New Orleans LA 70121 20 2J 1 none 1 2 2 29962614 90145095Ochsner Clinic Emerson S. Cameron 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 2 29962614 90145095Ochsner Clinic Epstein Nona K. PT 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Farris, Jr. Charles 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 2 29962614 90145095Ochsner Clinic Felipe-Ramirez Dania L. 1514 Jefferson Highway New Orleans LA 70121 20 2E 1 none 1 2 2 29962614 90145095Ochsner Clinic Fernandez Sara PT 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Fondas Anne L. 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic French E. Shane PT 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 2 29962614 90145095Ochsner Clinic Frisch, Jr. Richard F. 1514 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 2 29962614 90145095Ochsner Clinic Frohlich Edward D. PT 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Fuloria Jyotsna 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Gabbard William A. 1514 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962614 90145095Ochsner Clinic Gaines Kenneth J. 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic Gala Rajiv B. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Garces Jorge C. 1514 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962614 90145095Ochsner Clinic Gergatz Stephen J. 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Gilliland Yvonne E. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Girgrah Nigel 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Granier Steven J. 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Grise' Mark A. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Gunn Susan H. 1514 Jefferson Highway New Orleans LA 70121 20 29 1 none 1 2 2 29962614 90145095Ochsner Clinic Hassett Cathryn C. 1514 Jefferson Highway New Orleans LA 70121 20 03 1 none 1 2 2 29962614 90145095Ochsner Clinic Hawkins Roland B. 1514 Jefferson Highway New Orleans LA 70121 20 2J 1 none 1 2 2 29962614 90145095


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Head Lionel H. PT 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Hesse Richard J. 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 2 29962614 90145095Ochsner Clinic Hicks Terrell C. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Huff Shelley R. 1514 Jefferson Highway New Orleans LA 70121 28 88 1 none 1 2 2 29962614 90145095Ochsner Clinic Jackson Amanda B. 1514 Jefferson Highway New Orleans LA 70121 20 37 1 <=18 1 2 2 29962614 90145095Ochsner Clinic Jain Surma D. 1514 Jefferson Highway New Orleans LA 70121 20 29 1 none 1 2 2 29962614 90145095Ochsner Clinic Jenkins James S. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Johnson Kristin S. PT 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 1 29962614 90145095THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kantrow Stephen P. 1514 Jefferson Highway New Orleans LA 70121 20 29 1 none 1 2 2 29962614 90145095Ochsner Clinic Kaye Jefferson J. 1514 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 2 29962614 90145095Ochsner Clinic Khatib Sammy 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Kimball Jon P. 1514 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 1 29962614 90145095Ochsner Clinic Kirsh David S. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Kreutziger Keith L. 1514 Jefferson Highway New Orleans LA 70121 20 04 1 none 1 2 2 29962614 90145095Ochsner Clinic Kronenberg Frannie R. 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Kruger Ellen R. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Kullman Ginny L. 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 2 29962614 90145095Ochsner Clinic Kunjukunju Nancy 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 2 29962614 90145095Ochsner Clinic Laborde Eric L. 1514 Jefferson Highway New Orleans LA 70121 20 34 1 none 1 2 2 29962614 90145095Ochsner Clinic Lafaye Kristina M. 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic Lavie, Jr. Carl J. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Lea Georgia S. 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic Leary Gloria M. PT 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Lee Benjamin S. 1514 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962614 90145095Ochsner Clinic Leopold Rhonda G. 1514 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962614 90145095Ochsner Clinic Lessig Paul M. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Lindberg Paige E. 1514 Jefferson Highway New Orleans LA 70121 20 04 1 none 1 2 2 29962614 90145095Ochsner Clinic Linson J. David 1514 Jefferson Highway New Orleans LA 70121 28 88 1 none 1 2 2 29962614 90145095Ochsner Clinic Longo Sherri A. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Lopez Manuel PT 1514 Jefferson Highway New Orleans LA 70121 20 03 1 none 1 2 2 29962614 90145095Ochsner Clinic Lorio Chantal B. 1514 Jefferson Highway New Orleans LA 70121 32 48 1 none 1 2 2 29962614 90145095Ochsner Clinic Loss, Jr. George E. 1514 Jefferson Highway New Orleans LA 70121 20 33 1 none 1 2 2 29962614 90145095Ochsner Clinic Lotterman Craig D. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Mandras Stacy A. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Margolin David A. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Mazzulla Anthony D. 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 2 29962614 90145095Ochsner Clinic McCormick Mary L. PT 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic McLaren Robert H. 1514 Jefferson Highway New Orleans LA 70121 20 34 1 none 1 2 2 29962614 90145095Ochsner Clinic McMullan, Jr. Paul W. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Meggs Leonard G. 1514 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962614 90145095Ochsner Clinic Mejias Joaquin Crespo 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Mermiliod Julie A. 1514 Jefferson Highway New Orleans LA 70121 20 07 1 none 1 2 2 29962614 90145095Ochsner Clinic Meyer Mark S. 1514 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 2 29962614 90145095Ochsner Clinic Miceli, III Joseph A. 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Milani Richard V. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Moiz Abdul 1514 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962614 90145095Ochsner Clinic Molina, III Arthur 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Molony Timothy B. 1514 Jefferson Highway New Orleans LA 70121 20 04 1 none 1 2 2 29962614 90145095Ochsner Clinic Moore Brian A. PT 1514 Jefferson Highway New Orleans LA 70121 20 04 1 none 1 2 2 29962614 90145095Ochsner Clinic Moore Candace C. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 2 29962614 90145095


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Moore R. Clifton 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Moore Thomas A. 1514 Jefferson Highway New Orleans LA 70121 20 2I 1 none 1 2 2 29962614 90145095Ochsner Clinic Morris Brian G. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Morris, III George B. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Mott Frank E. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Mravik Krisztina Marton 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic Nelson Brian K. 1514 Jefferson Highway New Orleans LA 70121 28 88 1 none 1 2 2 29962614 90145095Ochsner Clinic Nelson Constance D. 1514 Jefferson Highway New Orleans LA 70121 28 88 1 none 1 2 2 29962614 90145095Ochsner Clinic Nussdorf Jonathan D. 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 2 29962614 90145095Ochsner Clinic Ochsner, Jr. J. Lockwood 1514 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 2 29962614 90145095Ochsner Clinic Ochsner, Sr. John L. PT 1514 Jefferson Highway New Orleans LA 70121 20 33 1 none 1 2 2 29962614 90145095Ochsner Clinic Opoku Boateng Adwoa S. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Oser, III Frank S. 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095THE PHYSICIAN'S ALLIANCE CORP (TPAC) Paige John T. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Panunti Brandy A. 1514 Jefferson Highway New Orleans LA 70121 20 2E 1 none 1 2 2 29962614 90145095Ochsner Clinic Parrino P. Eugene 1514 Jefferson Highway New Orleans LA 70121 20 33 1 none 1 2 2 29962614 90145095Ochsner Clinic Patel Hamang M. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Porter, III George H. PT 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Quinet Robert J. 1514 Jefferson Highway New Orleans LA 70121 20 2M 1 none 1 2 2 29962614 90145095Ochsner Clinic Rampolla Reinaldo E. 1514 Jefferson Highway New Orleans LA 70121 20 29 1 none 1 2 2 29962614 90145095Ochsner Clinic Rao Jayaraman 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic Rapp Jonathan A. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Re Richard N. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Reilly John P. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Rich Gary M. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Richards Lisa F. PT 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Richardson William S. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Riddick, Jr. Frank A. PT 1514 Jefferson Highway New Orleans LA 70121 20 2E 1 none 1 2 2 29962614 90145095Ochsner Clinic Riker Adam I. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Rivera Ramon E. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Roberie Margaret A. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Roberts Sean M. 1514 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962614 90145095Ochsner Clinic Rodriquez Kimsey H. 1514 Jefferson Highway New Orleans LA 70121 20 04 1 none 1 2 1 29962614 90145095Ochsner Clinic Rodriquez Ramona Granda 1514 Jefferson Highway New Orleans LA 70121 20 2E 1 none 1 2 2 29962614 90145095Ochsner Clinic Romero Ricardo V. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Roy Praveen K. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Sargent William T. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Sarmini Mahmoud M. 1514 Jefferson Highway New Orleans LA 70121 35 65 1 none 1 2 2 29962614 90145095Ochsner Clinic Satti Suma P 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Schipper James M. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Scopelitis Eve 1514 Jefferson Highway New Orleans LA 70121 20 2M 1 none 1 2 2 29962614 90145095Ochsner Clinic Scroggins Jr. Troy G. 1514 Jefferson Highway New Orleans LA 70121 20 2J 1 none 1 2 2 29962614 90145095Ochsner Clinic Serrano Maria-Stella 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Setty Shaun P. 1514 Jefferson Highway New Orleans LA 70121 20 33 1 none 1 2 1 29962614 90145095Ochsner Clinic Shah Sangeeta B. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Siegendorf Stacy D. PT 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Sisco Wise Leslie E. 1514 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 2 29962614 90145095Ochsner Clinic Smith Taylor A. 1514 Jefferson Highway New Orleans LA 70121 20 2P 1 none 1 2 2 29962614 90145095Ochsner Clinic St. Hilaire Hugo 1514 Jefferson Highway New Orleans LA 70121 20 24 1 none 1 2 1 29962614 90145095Ochsner Clinic St. John Fayne M. PT 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Sternbergh, III W. Charles 1514 Jefferson Highway New Orleans LA 70121 20 2P 1 none 1 2 2 29962614 90145095Ochsner Clinic Stoll James D. PT 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Sulaiman Olawale A.R. 1514 Jefferson Highway New Orleans LA 70121 20 14 1 none 1 2 2 29962614 90145095Ochsner Clinic Taylor David E. 1514 Jefferson Highway New Orleans LA 70121 20 29 1 none 1 2 2 29962614 90145095Ochsner Clinic Theodossiou Chris 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Thomas Austin C. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Thomas Patricia 1514 Jefferson Highway New Orleans LA 70121 20 1D 1 none 1 2 2 29962614 90145095Ochsner Clinic Thompson Laura L. 1514 Jefferson Highway New Orleans LA 70121 28 88 1 none 1 2 2 29962614 90145095Ochsner Clinic Thornton Stanley N. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Tillis Cea C. 1514 Jefferson Highway New Orleans LA 70121 20 1C 1 none 1 2 2 29962614 90145095Ochsner Clinic Townsend Michael C. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Treuting Robert J. 1514 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 2 29962614 90145095Ochsner Clinic Urrego Fernando A. 1514 Jefferson Highway New Orleans LA 70121 20 29 1 none 1 2 1 29962614 90145095Ochsner Clinic Uwaifo Omotola O. 1514 Jefferson Highway New Orleans LA 70121 20 1C 1 none 1 2 2 29962614 90145095Ochsner Clinic Vockroth Ann E. PT 1514 Jefferson Highway New Orleans LA 70121 20 03 1 none 1 2 2 29962614 90145095Ochsner Clinic Waddadar Jay 1514 Jefferson Highway New Orleans LA 70121 20 2E 1 none 1 2 2 29962614 90145095Ochsner Clinic Wakabashi Masako N. PT 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Walia Suneeta S. 1514 Jefferson Highway New Orleans LA 70121 20 07 1 none 1 2 2 29962614 90145095Ochsner Clinic Ware Marcus L. 1514 Jefferson Highway New Orleans LA 70121 20 14 1 none 1 2 1 29962614 90145095Ochsner Clinic Wells Adam C. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 1 29962614 90145095Ochsner Clinic Wendling, Jr. Charles V. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic White Christopher J. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Wild Laurianne G. 1514 Jefferson Highway New Orleans LA 70121 20 03 1 none 1 2 2 29962614 90145095Ochsner Clinic Wilson, IV Frederic B. 1514 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 2 29962614 90145095Ochsner Clinic Winstead Nathaniel S. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Winters J. Christian 1514 Jefferson Highway New Orleans LA 70121 20 34 1 none 1 2 2 29962614 90145095Ochsner Clinic Wise M. Whitten 1514 Jefferson Highway New Orleans LA 70121 20 24 1 none 1 2 2 29962614 90145095Ochsner Clinic Witherspoon Lynn R. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Wooldrige, Jr. James B. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Zakem Jerald M. 1514 Jefferson Highway New Orleans LA 70121 20 2M 1 none 1 2 2 29962614 90145095Ochsner Clinic Zavatsky Joseph M. 1514 Jefferson Highway New Orleans LA 70121 20 20 1 none 1 2 2 29962614 90145095Ochsner Clinic Bates Michael J. 1514 Jefferson Highway New Orleans LA 70121 20 33 1 none 1 2 2 29962614 90145095Ochsner Clinic Baumgarten Katherine 1514 Jefferson Highway New Orleans LA 70121 20 2I 1 none 1 2 2 29962614 90145095Ochsner Clinic Bazzett Lisa B. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 2 29962614 90145095Ochsner Clinic Beck David E. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Bethi Krishnaveni S. 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Burns C. Braddock 1514 Jefferson Highway New Orleans LA 70121 20 29 1 none 1 2 2 29962614 90145095Ochsner Clinic Cazabon Pedro 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Cederbom Gunnar 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Charbonnet Nicole M. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 2 29962614 90145095Ochsner Clinic Coit Catherine S. 1514 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962614 90145095Ochsner Clinic Dalovisio Joseph R. 1514 Jefferson Highway New Orleans LA 70121 20 2I 1 none 1 2 2 29962614 90145095Ochsner Clinic David, III W. Edward PT 1514 Jefferson Highway New Orleans LA 70121 20 03 1 none 1 2 2 29962614 90145095Ochsner Clinic DeVun Daniel 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Diethelm Nancy E. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Dowling Adam M. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Eick John J. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Emerson Noah A. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 1 29962614 90145095Ochsner Clinic Emory W. Brooks 1514 Jefferson Highway New Orleans LA 70121 20 29 1 none 1 2 2 29962614 90145095Ochsner Clinic Eustis, Jr. H. Sprague 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 1 29962614 90145095


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Garcia-Diaz Julia B. 1514 Jefferson Highway New Orleans LA 70121 20 2I 1 none 1 2 2 29962614 90145095Ochsner Clinic Gillispie Veronica G. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Guillmette Jeffery A. 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 2 29962614 90145095Ochsner Clinic Hamilton Monique P. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Husserl Fred E. 1514 Jefferson Highway New Orleans LA 70121 20 2K 1 none 1 2 2 29962614 90145095Ochsner Clinic Jancich Sophy A. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Joshi Shobha N. 1514 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962614 90145095Ochsner Clinic Kaliebe Olga 1514 Jefferson Highway New Orleans LA 70121 20 2E 1 none 1 2 2 29962614 90145095Ochsner Clinic Kalmar John A. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 1 29962614 90145095Ochsner Clinic Kay Dennis 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Kemmerly Sandra A. 1514 Jefferson Highway New Orleans LA 70121 20 2I 1 none 1 2 2 29962614 90145095Ochsner Clinic Kenney, III Arthur J. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 1 29962614 90145095Ochsner Clinic Kline Richard C. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 2 29962614 90145095Ochsner Clinic Lapeyre Elizabeth 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Larned Zoe L. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Layman Todd E. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 1 29962614 90145095Ochsner Clinic Lecce Michael D. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Liokis Evangelos A. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Loftfield Katherine M. 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 2 29962614 90145095Ochsner Clinic Matthews Charles C. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic McBurney Donald B. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Mello Dennis M. 1514 Jefferson Highway New Orleans LA 70121 20 1D 1 none 1 2 1 29962614 90145095Ochsner Clinic Milburn Cristina I. PT 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Milburn James M. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 1 29962614 90145095Ochsner Clinic Montelibano Lawrence E. 1514 Jefferson Highway New Orleans LA 70121 20 03 1 none 1 2 2 29962614 90145095Ochsner Clinic Montgomery Melissa M. 1514 Jefferson Highway New Orleans LA 70121 20 34 1 none 1 2 2 29962614 90145095Ochsner Clinic Morin Daniel P. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Morris, IV George B. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Mulder Theodorus J. 1514 Jefferson Highway New Orleans LA 70121 20 1D 1 none 1 2 1 29962614 90145095Ochsner Clinic Nachar Oussama 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Nelson Twakor Onajefe S. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Osinbowale Olsugun O. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Pankey George A. PT 1514 Jefferson Highway New Orleans LA 70121 20 2I 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Parise Angela M. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Patel Rajan A. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Prats, Jr. Lester J. 1514 Jefferson Highway New Orleans LA 70121 20 34 1 none 1 2 2 29962614 90145095Ochsner Clinic Ramee Stephen R. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Ramsay R. Eugene 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic Ray Marilyn C. 1514 Jefferson Highway New Orleans LA 70121 20 07 1 none 1 2 2 29962614 90145095Ochsner Clinic Redillas Carol R. 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic Robichaux, III Alfred G. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 1 29962614 90145095Ochsner Clinic Saucier Michael A. 1514 Jefferson Highway New Orleans LA 70121 35 65 1 none 1 2 2 29962614 90145095Ochsner Clinic Selden Basil H. 1514 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962614 90145095Ochsner Clinic Shah Pulin A. 1514 Jefferson Highway New Orleans LA 70121 20 18 1 none 1 2 2 29962614 90145095Ochsner Clinic Smetherman Dana H. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Smith Roger D. 1514 Jefferson Highway New Orleans LA 70121 20 14 1 none 1 2 2 29962614 90145095Ochsner Clinic Sossaman Gregory N. 1514 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 1 29962614 90145095Ochsner Clinic Sossaman Julie G. PT 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic St. Pierre Jerry J. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 2 29962614 90145095Ochsner Clinic Sullivan Michael A. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Tamma Srikanth 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Teaford T. Lamar 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962614 90145095Ochsner Clinic Timmcke Alan E. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Togami Joanna 1514 Jefferson Highway New Orleans LA 70121 20 34 1 none 1 2 2 29962614 90145095Ochsner Clinic Tupler Richard H. 1514 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 1 29962614 90145095Ochsner Clinic Van Horn, III Herbert W. 1514 Jefferson Highway New Orleans LA 70121 20 04 1 none 1 2 2 29962614 90145095Ochsner Clinic Vanlangendonck, Jr. Richard M. 1514 Jefferson Highway New Orleans LA 70121 20 34 1 none 1 2 2 29962614 90145095Ochsner Clinic Ventura Hector O. 1514 Jefferson Highway New Orleans LA 70121 20 06 1 none 1 2 2 29962614 90145095Ochsner Clinic Vidal Gabriel A. 1514 Jefferson Highway New Orleans LA 70121 20 13 1 none 1 2 2 29962614 90145095Ochsner Clinic Warrier Rajasekharan P. 1514 Jefferson Highway New Orleans LA 70121 20 2H 1 none 1 2 2 29962614 90145095Ochsner Clinic Webb Detiege Tamika A. 1514 Jefferson Highway New Orleans LA 70121 20 2M 1 none 1 2 2 29962614 90145095Ochsner Clinic White Anna M. 1514 Jefferson Highway New Orleans LA 70121 20 16 1 >=16 1 2 2 29962614 90145095Ochsner Clinic Whitlow Charles B. 1514 Jefferson Highway New Orleans LA 70121 20 02 1 none 1 2 2 29962614 90145095Ochsner Clinic Woo Howard H. 1514 Jefferson Highway New Orleans LA 70121 20 34 1 none 1 2 2 29962614 90145095Ochsner Clinic Young Thomas W. 1514 Jefferson Highway New Orleans LA 70121 20 1D 1 none 1 2 1 29962614 90145095Ochsner Foundation Hospital 1514 Jefferson Hwy New Orleans LA 70121 60 86 1 none 1 2 1 29962614 90145095Ochsner Clinic Bergeron Desiree' 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Abbas Alyson 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Adams Lessley B. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Allen Elizabeth 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Ball Pam K. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Battley Lisa A. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Bell Kathy 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Binggeli Shanelle 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Brady Maria B. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Brandon Nora 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Brandt Julie 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Brandt Victoria 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Brown Matthew 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Burg Mary H. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Bush Giselle 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Bush Stephanie 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Castellucci Carol A. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Cerise Monique 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Chandler Beryl K. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Cohen Aaron 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Cohen Laura A. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Colomer Mary E. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Conway Caroline 1516 Jefferson Hwy. New Orleans LA 70121 78 16 1 >=16 1 2 2 29962660 90145388Ochsner Clinic Corkern Kelly B. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Corsetti Jina 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Crespo Paige 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Cruise Grover S. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Darrah Rebecca 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Davis Kelly 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic DeBlanc Shannon 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Dobie David O. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Douglass Stephanie 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Eckert Megan 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Fogarty Lillie 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Fulk Vicki J. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Gachassin Leslie 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Glass Shane P. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Graham Nicole H. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Gremillion Patricia 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Gubert Norbert B. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Hall Holli H. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Harvantin Teresa M. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Hill Katherine 1516 Jefferson Hwy. New Orleans LA 70121 78 16 1 >=16 1 2 2 29962660 90145388Ochsner Clinic Hoerner Maria D. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Hoffman Kelley 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Jenkins Melissa N. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Jurisih Julia 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic King Richard S. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Kraft Michelle R. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Lacaze Michelle K. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Langston Sherry M. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic LeBlan Nanette 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Ledet Jay 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Lilley Deena S. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Lockhart Melanie 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 1 29962660 90145388Ochsner Clinic Lynch James W. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Mahony Mark P. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic McDonald Regina 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic McLindon Ann 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Millet Kevin 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Millet Whitney B. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Moore Billie 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Mysing Judith 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Nelson Elizabeth 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Neyland Carrie L. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Orellana Melinda 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Pennier Margaret 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Plauche Lisa B. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Poche Carolyn 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Primeaux Mimi G. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Pryor Karen 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Reed Frances A. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Robeau Kymberly G. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Robinson Catherine 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Skific Karen 1516 Jefferson Hwy. New Orleans LA 70121 78 37 1 <=18 1 2 2 29962660 90145388Ochsner Clinic St. Germain Gina M. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Thomas-Harwood Charlotte T. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Vasek Rachel Murff 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Walker Valerie R. 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Williams Stephanie 1516 Jefferson Hwy. New Orleans LA 70121 91 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Baker Jeffery A. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Beckman Edwin N. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Busch Eric H. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Carroll Vanessa G. 1516 Jefferson Highway New Orleans LA 70121 20 37 1 <=18 1 2 2 29962660 90145388


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Carter William J. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Cheuk Joan W. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Coffin David T. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Colon Jimmie E. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Combs Brent K. 1516 Jefferson Highway New Orleans LA 70121 19 1T 1 none 1 2 1 29962660 90145388Ochsner Clinic Conrad Kevin M. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Cooke Erin A. 1516 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962660 90145388Ochsner Clinic Cooper E. Shannon 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Corsino Daniel P. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Cousins Darren S. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Cousins James R. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Cousins Randolph E. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Daly, Jr. William J. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Davis Nancy Kang 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Deitelzweig Steven B. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Dennis Patrick M. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Diggs Erica A. PT 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Elliot Clint E. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Emory Logan S. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Evans Bryan M. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Faust Barry 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Gandle Bruce PT 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Ganier, Jr. Donald R. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Garcia-Prats Victor M. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Genre Charles F. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Ginsberg Harley G. 1516 Jefferson Highway New Orleans LA 70121 20 1C 1 none 1 2 1 29962660 90145388Ochsner Clinic Guarisco Joseph S. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Gutkin Alexander I. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Hanley James R. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Harmon Donald E. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Hart Stuart R. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Hayden Dorothy V. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Hevia, III Armando 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Islam Humayun K. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Karnik Vilasini S. PT 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Knox, IV William J. 1516 Jefferson Highway New Orleans LA 70121 20 30 1 none 1 2 2 29962660 90145388Ochsner Clinic Kuo Jeffrey S. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 1 29962660 90145388Ochsner Clinic LeBoeuf Matthew H. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Lee David H. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Lunyong Victor E. 1516 Jefferson Highway New Orleans LA 70121 20 1C 1 none 1 2 1 29962660 90145388Ochsner Clinic Marier Robert L. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Marino Robert J. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Matte Melissa C. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Maumus Marianne 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Mayeaux Carl A. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic McConnell Richard Y. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic McDonald Patrick F. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic McDonald Stacy W. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic McNulty Patrick A. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Meadows Renee Y. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Moises James P. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Monnat Paula M. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Najberg Christopher J. 1516 Jefferson Highway New Orleans LA 70121 19 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Nath Arup K. 1516 Jefferson Highway New Orleans LA 70121 19 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Nossaman Bobby D. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Park Jason L. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Pasala Satish 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Pei Leo A. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Phillips, Jr. Austin G. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Porada Patricia C. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Porche Brian L. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Ramadhyani Usha 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Ritter Melody J. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Rodwig, Jr. Francis R. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 1 29962660 90145388Ochsner Clinic Russo Melissa B. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Sabharwal Vivek 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Sea Charles P. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Seoane Leonardo 1516 Jefferson Highway New Orleans LA 70121 20 29 1 none 1 2 2 29962660 90145388Ochsner Clinic Smilari Thom F. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Smith James W. 1516 Jefferson Highway New Orleans LA 70121 20 10 1 none 1 2 2 29962660 90145388Ochsner Clinic Sprintz Michael P. 1516 Jefferson Highway New Orleans LA 70121 19 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Starr Barry M. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Stedman Peter M. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Stedman Robin B. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Subaiya Chitralekha 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Sumrall W. David 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Sundell Erik T. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Tang Wendell W. 1516 Jefferson Highway New Orleans LA 70121 20 22 1 none 1 2 2 29962660 90145388Ochsner Clinic Taylor Connie E. 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Tedesco, IV W. Oren 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Thomas Leslie C. PT 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Thomas Liza DiLeo 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Thomas Mack A. PT 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Thompson Roxanne C. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 1 29962660 90145388Ochsner Clinic Troxler William M. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Truxillo T. Michael 1516 Jefferson Highway New Orleans LA 70121 20 05 1 none 1 2 2 29962660 90145388Ochsner Clinic Vogel Susan L. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Voigt Christopher M. 1516 Jefferson Highway New Orleans LA 70121 20 1T 1 none 1 2 2 29962660 90145388Ochsner Clinic Vuppala Srinivas 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Wharton Frank C. 1516 Jefferson Highway New Orleans LA 70121 20 41 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Matranga Gerry 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Pennier Carsten 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Perkins Shannon 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Rivera Donna 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Strecker Kristine 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388Ochsner Clinic Traylor Jeanne S. 1516 Jefferson Hwy. New Orleans LA 70121 78 79 1 >=18 1 2 2 29962660 90145388OCHSNER DURABLE MEDICAL EQUIPMENT 1601 Jefferson Hwy, Ste. A New Orleans LA 70121 40 54 1 none 1 2 2 29963101 90145298EXCELTH FAMILY HEALTH CENTER 2050 Caton St New Orleans LA 70122 72 9L 1 none 1 2 2 29998650 90062082EXCELTH FAMILY HEALTH CENTER Donaldson-Bailey Michelle D. POD 2050 Caton St New Orleans LA 70122 32 48 1 >=18 1 2 2 29998650 90062082EXCELTH FAMILY HEALTH CENTER Edwards Danielle MD 2050 Caton St New Orleans LA 70122 20 08 1 None 1 2 2 29998650 90062082


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

EXCELTH FAMILY HEALTH CENTER Gonzales Lolita MD 2050 Caton St New Orleans LA 70122 20 37 1 <=18 1 2 2 29998650 90062082EXCELTH FAMILY HEALTH CENTER Meyn Madelyn MD 2050 Caton St New Orleans LA 70122 20 37 1 <=18 1 2 2 29998650 90062082EXCELTH FAMILY HEALTH CENTER Ogbuefi Chioma MD 2050 Caton St New Orleans LA 70122 20 41 1 >=18 1 2 2 29998650 90062082EXCELTH FAMILY HEALTH CENTER Shalaby Mona MD 2050 Caton St New Orleans LA 70122 20 08 1 none 1 2 2 29998650 90062082EXCELTH FAMILY HEALTH CENTER Shalaby Monir MD 2050 Caton St New Orleans LA 70122 20 37 1 none 1 2 2 29998650 90062082EXCELTH FAMILY HEALTH CENTER Winfrey Wylea G. MN, FNP-C 2050 Caton St New Orleans LA 70122 78 08 1 >=18 1 2 2 29998650 90062082EXCELTH FAMILY HEALTH CENTER Imseis Manuel MD 2050 Caton St. New Orleans LA 70122 20 37 1 none 1 2 2 29998650 90062082KLEAMENAKIS MICHAEL N OD Kleamenakis Michael 4114 Marigny St New Orleans LA 70122 28 88 1 none 1 2 1 30000821 90058221KLEAMENAKIS MICHAEL N OD Songy Brock Joachim OD 4114 Marigny St New Orleans LA 70122 28 88 1 none 1 2 2 30000821 90058221GLEN C CANGELOSI MD LLC Cangelosi Glen C. MD 4201 Frenchmen St New Orleans LA 70122 20 18 1 none 1 2 2 30001073 90060569ROBERT J CANGELOSI, MD Cangelosi Robert J. MD 4201 Frenchmen St New Orleans LA 70122 20 18 1 none 1 2 2 30001073 90060569GLEN C CANGELOSI MD LLC Langhetee Henry P. OD 4201 Frenchmen St New Orleans LA 70122 28 88 1 none 1 2 1 30001073 90060569THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sylvester Stephen 4298 Elysian Fields Suite C New Orleans LA 70122 35 65 1 none 1 2 2 30001854 90059771LOUISIANA AVENUE MEDICAL CENTER INC 4301 Elysian Fields Avenue New Orleans LA 70122 20 08 1 None 1 2 2 30002166 90059133LOUISIANA AVENUE MEDICAL CENTER INC Barconey Monique D. 4301 Elysian Fields Avenue New Orleans LA 70122 78 08 1 none 1 2 2 30002166 90059133THE PHYSICIAN'S ALLIANCE CORP (TPAC) Evans Henry 4301 Elysian Fields Avenue New Orleans LA 70122 20 08 1 None 1 2 1 30002166 90059133LOUISIANA AVENUE MEDICAL CENTER INC Evans, Jr. Henry M. MD 4301 Elysian Fields Avenue New Orleans LA 70122 20 08 1 none 1 2 1 30002166 90059133LOUISIANA AVENUE MEDICAL CENTER INC Gaiter-Stampley Vonda 4301 Elysian Fields Avenue New Orleans LA 70122 78 08 1 none 1 2 2 30002166 90059133MARY T. SHERIFF, DPM Sheriff Mary T. DPM 4301 Elysian Fields Avenue Suite 102 New Orleans LA 70122 32 48 1 none 1 2 1 30002166 90059133WARREN H JOHNSON Johnson Warren H. DPM 6305 Elysian Fields Ave #204 New Orleans LA 70122 32 48 1 none 1 2 1 30023345 90060828Quest Diagnostics 6305 Elysian Fields Avenue Suite 302 New Orleans LA 70122 20 30 1 none 1 1 2 30023345 90060828MASTERS MEDICAL 1500 Edwards Ave. Ste N Harahan LA 70123 40 54 1 none 1 2 2 29961721 90195484SOUTHEAST MEDICAL SUPPLY 1501 River Oaks Road West Harahan LA 70123 40 54 1 none 1 2 2 29960432 90202620LINCARE INC 1533 SAMS AVENUE SUITE D HARAHAN LA 70123 40 54 1 none 1 1 2 29962955 90198964EYECARE 2020 Notaroberto Neil F. 1939 Hickory Ave Suite 101 Harahan LA 70123 20 18 1 none 1 2 2 29966750 90206556GULF COAST MEDICAL EQUIPMENT 36 Commerce Ct. Ste A Harahan LA 70123 40 54 1 >=18 1 2 2 29949136 90187454DELTA MEDICAL EQUIPMENT AND SUPPLY 551 Hickory Avenue Harahan LA 70123 40 54 1 none 1 2 1 29944539 90198381NATIONAL SEATING & MOBILITY 5515 Pepsi St. Ste A&B Harahan LA 70123 40 54 1 none 1 2 2 29951105 90187135DIABETES MANAGEMENT & SUPPLIES LLC 10 Commerce Court Suite B New Orleans LA 70123 40 54 1 none 1 2 1 29949178 90187303Apria Healthcare, Inc. 1510 Kuebel St New Orleans LA 70123 40 54 1 none 1 1 2 29962845 90193305LINCARE INC 5701 Crawford St Ste D New Orleans LA 70123 40 29 1 none 1 2 1 29963384 90197385LINCARE INC DBA PS HOMECA 5701 CRAWFORD ST SUITE D NEW ORLEANS LA 70123 40 54 1 none 1 1 2 29963384 90197385Jefferson Community Health Care Centers 11312 Jefferson Hwy River Ridge LA 70123 72 9L 1 none 1 2 2 29970324 90235835Jefferson Community Health Care Centers Allen Renetta 11312 Jefferson Hwy River Ridge LA 70123 78 08 1 None 1 2 2 29970324 90235835Jefferson Community Health Care Centers Curole David MD 11312 Jefferson Hwy River Ridge LA 70123 20 16 1 >=16 1 2 1 29970324 90235835Jefferson Community Health Care Centers Dumas Jeremy MD 11312 Jefferson Hwy River Ridge LA 70123 20 41 1 >=18 1 2 2 29970324 90235835Jefferson Community Health Care Centers McNeil Vonder 11312 Jefferson Hwy River Ridge LA 70123 78 08 1 None 1 2 2 29970324 90235835Jefferson Community Health Care Centers Pandit Bharathi MD 11312 Jefferson Hwy River Ridge LA 70123 20 37 1 <=18 1 2 2 29970324 90235835Jefferson Community Health Care Centers Price Genelle MD 11312 Jefferson Hwy River Ridge LA 70123 20 41 1 >=18 1 2 2 29970324 90235835Jefferson Community Health Care Centers Salgado Maritza NP 11312 Jefferson Hwy River Ridge LA 70123 78 08 1 None 1 2 2 29970324 90235835Jefferson Community Health Care Centers Verrett LaJuan 11312 Jefferson Hwy River Ridge LA 70123 78 08 1 None 1 2 2 29970324 90235835Jefferson Community Health Care Centers Warrier Jaya MD 11312 Jefferson Hwy River Ridge LA 70123 20 08 1 None 1 2 2 29970324 90235835Jefferson Community Health Care Centers Wolfson Neil MD 11312 Jefferson Hwy River Ridge LA 70123 20 16 1 >=16 1 2 2 29970324 90235835Ochsner Clinic Area Leandro C. 101 W. Robert E. Lee Blvd. Suite 201 New Orleans LA 70124 20 08 1 None 1 2 2 30020294 90114655Ochsner Clinic Berner Tara G. 101 W. Robert E. Lee Blvd. Suite 201 New Orleans LA 70124 20 08 1 None 1 2 2 30020294 90114655Ochsner Clinic Holt Sarah W. 101 W. Robert E. Lee Blvd. Suite 201 New Orleans LA 70124 19 08 1 None 1 2 2 30020294 90114655Ochsner Clinic Innocent Ituah ljeoma N. 101 W. Robert E. Lee Blvd. Suite 201 New Orleans LA 70124 20 08 1 None 1 2 2 30020294 90114655Ochsner Clinic Olivier Sherise R. 101 W. Robert E. Lee Blvd. Suite 201 New Orleans LA 70124 20 08 1 None 1 2 2 30020294 90114655Ochsner Clinic Moore Candace C. 102 W. Robert E. Lee Blvd. New Orleans LA 70124 20 16 1 >=16 1 2 2 30020026 90114585LOUISIANA AVENUE MEDICAL CENTER INC Gaiter-Stampley Vonda 5712 South Claiborne Avenue New Orleans LA 70125 78 08 1 none 1 2 2 29942482 90111832


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

D M E DIRECT LLC 105 Harbor Circle New Orleans LA 70126 40 54 1 none 1 2 2 30028777 90028233MEDICINE & NEPHROLOGY CLINIC OF NEW ORLEANS Okonkwo Ndubueze Fidelis 5571 Read Blvd. New Orleans LA 70127 20 41 1 >=18 1 2 1 30031128 89971451MINH C DAO Dao Minh C. MD 4657 Alcee Fortiar Blvd New Orleans LA 70129 20 41 1 none 1 2 1 30037183 89911585THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hebert Catherine M. 1020 St. Andrew Street New Orleans LA 70130 20 41 1 >=18 1 2 2 29923170 90072299LABCORP 1716 SAINT CHARLES AVE NEW ORLEANS LA 70130 20 30 1 none 1 1 2 29937212 90076593EXCELTH FAMILY HEALTH CENTER 4422 General Meyer Ave Ste 103 New Orleans LA 70131 72 9L 1 none 1 2 2 29934514 90008534EXCELTH FAMILY HEALTH CENTER Donaldson-Bailey Michelle D. POD 4422 General Meyer Ave Ste 103 New Orleans LA 70131 32 48 1 >=18 1 2 2 29934514 90008534EXCELTH FAMILY HEALTH CENTER Edwards Danielle MD 4422 General Meyer Ave Ste 103 New Orleans LA 70131 20 08 1 None 1 2 2 29934514 90008534EXCELTH FAMILY HEALTH CENTER Gonzales Lolita MD 4422 General Meyer Ave Ste 103 New Orleans LA 70131 20 37 1 <=18 1 2 2 29934514 90008534EXCELTH FAMILY HEALTH CENTER Imseis Manuel MD 4422 General Meyer Ave Ste 103 New Orleans LA 70131 20 37 1 none 1 2 2 29934514 90008534EXCELTH FAMILY HEALTH CENTER Meyn Madelyn MD 4422 General Meyer Ave Ste 103 New Orleans LA 70131 20 37 1 <=18 1 2 2 29934514 90008534EXCELTH FAMILY HEALTH CENTER Ogbuefi Chioma MD 4422 General Meyer Ave Ste 103 New Orleans LA 70131 20 41 1 >=18 1 2 2 29934514 90008534EXCELTH FAMILY HEALTH CENTER Shalaby Mona MD 4422 General Meyer Ave Ste 103 New Orleans LA 70131 20 08 1 none 1 2 2 29934514 90008534EXCELTH FAMILY HEALTH CENTER Shalaby Monir MD 4422 General Meyer Ave Ste 103 New Orleans LA 70131 20 37 1 none 1 2 2 29934514 90008534EXCELTH FAMILY HEALTH CENTER Winfrey Wylea G. MN, FNP-C 4422 General Meyer Ave Ste 103 New Orleans LA 70131 78 08 1 >=18 1 2 2 29934514 90008534OCHSNER DURABLE MEDICAL EQUIPMENT P.O. Box 54177 New Orleans LA 70154 40 54 1 none 1 2 2 29921030 90100096THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hebert Craig 104 East Bayou Road Thibodaux LA 70301 35 65 1 none 1 2 2 29799937 90817448THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pate Craig 104 East Bayou Road Thibodaux LA 70301 35 65 1 none 1 2 2 29799937 90817448THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tabor Tonya 104 East Bayou Road Thibodaux LA 70301 35 65 1 none 1 2 2 29799937 90817448Thibodaux Regional Network Developm Espinoza Luis R MD 1105 Audubon Ave Ste B Thibodaux LA 70301 20 41 1 >=18 1 2 1 29784717 90806889Grafton Dermatology Charbonnet Tamela MD 1253 Canal Blvd Thibodaux LA 70301 20 07 1 None 1 2 2 29786033 90822075Grafton Dermatology Grafton Lee H MD 1253 Canal Blvd Thibodaux LA 70301 20 07 1 None 1 2 2 29786033 90822075D & M HOME MEDICAL LLC 1713 Canal Blvd. Thibodaux LA 70301 40 54 1 none 1 2 1 29779716 90818696MITCHELL DAVID M OD Mitchell David 302 Ridgefield Rd. Thibodaux LA 70301 28 88 1 none 1 2 2 29794337 90827359CUSTOM HEALTHCARE INC Callahan Mike E. 314 West Main Street Thibodaux LA 70301 40 54 1 none 1 2 2 29769017 90816069Women's OB-Gyn Health & Wellness Andre Michelle M MD 406 N Acadia Rd Thibodaux LA 70301 20 16 1 12-65 2 1 2 29784687 90811145Women's OB-Gyn Health & Wellness Floyd John C MD 406 N Acadia Rd Thibodaux LA 70301 20 16 1 12-65 2 1 2 29784687 90811145The Hearing Clinic Lo Catherine C AUD 527 Foret St Thibodaux LA 70301 64 1 None 1 2 2 29793993 90811285AUDIBEL HEARING HEALTHCARE 531 Green St Thibodaux LA 70301 34 64 1 none 1 2 2 29795998 90819773Thibodaux Regional Network Developm Acosta Clel MD 602 N Acadia Rd Thibodaux LA 70301 20 05 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Arthurs Blain C MD 602 N Acadia Rd Thibodaux LA 70301 20 30 1 None 1 2 1 29778514 90804790Thibodaux Regional Network Developm Authement Chris MD 602 N Acadia Rd Thibodaux LA 70301 20 1T 1 None 1 2 1 29778514 90804790Thibodaux Regional Network Developm Bravo Jorge MD 602 N Acadia Rd Thibodaux LA 70301 20 05 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Degruise Brandi NP 602 N Acadia Rd Thibodaux LA 70301 78 87 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Del Riego Christopher MD 602 N Acadia Rd Thibodaux LA 70301 20 1T 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Diket Albert MD 602 N Acadia Rd Thibodaux LA 70301 20 16 1 >=16 Female 1 2 2 29778514 90804790Thibodaux Regional Network Developm Fakier Jay P MD 602 N Acadia Rd Thibodaux LA 70301 20 30 1 None 1 2 1 29778514 90804790Thibodaux Regional Network Developm Ferguson Christopher P MD 602 N Acadia Rd Thibodaux LA 70301 20 1T 1 None 1 2 1 29778514 90804790Thibodaux Regional Network Developm Gimenez Carlos MD 602 N Acadia Rd Thibodaux LA 70301 20 30 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Hargett Richard CRNA 602 N Acadia Rd Thibodaux LA 70301 91 05 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Harris Julie CRNA 602 N Acadia Rd Thibodaux LA 70301 91 05 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Kimble Christopher CRNA 602 N Acadia Rd Thibodaux LA 70301 91 05 1 None 1 2 1 29778514 90804790Thibodaux Regional Network Developm Lacombe Douglas CRNA 602 N Acadia Rd Thibodaux LA 70301 91 05 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Mabry Sharon NP 602 N Acadia Rd Thibodaux LA 70301 78 87 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Morvant James CRNA 602 N Acadia Rd Thibodaux LA 70301 91 05 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Naul David CRNA 602 N Acadia Rd Thibodaux LA 70301 91 05 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Newman Mark MD 602 N Acadia Rd Thibodaux LA 70301 20 16 1 >=16 Female 1 2 2 29778514 90804790Thibodaux Regional Network Developm Nguyen Tung MD 602 N Acadia Rd Thibodaux LA 70301 20 05 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Nicholas Blainey MD 602 N Acadia Rd Thibodaux LA 70301 20 1T 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Ochsner Isabel MD 602 N Acadia Rd Thibodaux LA 70301 20 1T 1 None 1 2 2 29778514 90804790


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

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2nd Line of Address

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Thibodaux Regional Network Developm Owens Michael MD 602 N Acadia Rd Thibodaux LA 70301 20 1T 1 None 1 2 1 29778514 90804790Thibodaux Regional Network Developm Pierre Emile MD 602 N Acadia Rd Thibodaux LA 70301 20 1T 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Savoie Craig CRNA 602 N Acadia Rd Thibodaux LA 70301 91 05 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Speights Charles MD 602 N Acadia Rd Thibodaux LA 70301 20 1T 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm St Amant Marshall MD 602 N Acadia Rd Thibodaux LA 70301 20 16 1 >=16 Female 1 2 2 29778514 90804790Thibodaux Regional Network Developm Stedman Charles MD 602 N Acadia Rd Thibodaux LA 70301 20 16 1 >=16 Female 1 2 2 29778514 90804790Thibodaux Regional Network Developm Teschke Eric MD 602 N Acadia Rd Thibodaux LA 70301 20 1T 1 None 1 2 2 29778514 90804790

Thibodaux Regional Medical Center 602 N Acadia Rd Thibodaux LA 70301 60 86 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Tosh John MD 602 N Acadia Rd Thibodaux LA 70301 20 1T 1 None 1 2 1 29778514 90804790Thibodaux Regional Network Developm Veillon Edward MD 602 N Acadia Rd Thibodaux LA 70301 20 16 1 >=16 Female 1 2 2 29778514 90804790Thibodaux Regional Network Developm Vilcan Vicky CRNA 602 N Acadia Rd Thibodaux LA 70301 91 05 1 None 1 2 2 29778514 90804790Thibodaux Regional Network Developm Voisin Jay CRNA 602 N Acadia Rd Thibodaux LA 70301 91 05 1 None 1 2 1 29778514 90804790Thibodaux Regional Network Developm Awasthi Deepak MD 604 N Acadia Rd Ste 410 Thibodaux LA 70301 20 14 1 None 1 2 2 29778300 90804565Thibodaux Regional Network Developm Dobard Gregory MD 604 N Acadia Rd Thibodaux LA 70301 20 30 1 None 1 2 2 29778300 90804565Thibodaux Regional Network Developm Donner Thomas MD 604 N Acadia Rd Ste 410 Thibodaux LA 70301 20 14 1 None 1 2 2 29778300 90804565Thibodaux Regional Network Developm Fudge Tommy L MD 604 N Acadia Rd Ste 409 Thibodaux LA 70301 20 30 1 None 1 2 2 29778300 90804565Thibodaux Regional Network Developm Leichty Peter MD 604 N Acadia Rd Ste 410 Thibodaux LA 70301 20 14 1 None 1 2 2 29778300 90804565Thibodaux Regional Network Developm Smith Laurence MD 604 N Acadia Rd Ste 409 Thibodaux LA 70301 20 30 1 None 1 2 2 29778300 90804565S K DONEPUDI MD APMC Donepudi Sarat K. MD 604 N. Acadia Rd. Suite 202 Thibodaux LA 70301 20 08 1 None 1 2 1 29778300 90804565Thibodaux Regional Network Developm Campbell Laura MD 608 N Acadia Rd Thibodaux LA 70301 20 2H 1 None 1 2 2 29778188 90804451Thibodaux Regional Network Developm Dunn William H MD 608 N Acadia Rd Thibodaux LA 70301 20 30 1 None 1 2 2 29778188 90804451Thibodaux Regional Network Developm Ellis James MD 608 N Acadia Rd Thibodaux LA 70301 20 2H 1 None 1 2 2 29778188 90804451THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gould Raymond 608 North Acadia Road Thibodaux LA 70301 20 2J 1 none 1 2 2 29778188 90804451Thibodaux Vision Center Inc Roy Mark OD 640 St Charles St Thibodaux LA 70301 28 88 1 None 2 1 1 29814661 90832886ROY III MARK J ODM Roy, III Mark OD 640 St. Charles Street Thibodaux LA 70301 28 88 1 none 1 2 1 29832537 90812584THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daigle John 808 Bayou Lane Thibodaux LA 70301 35 65 1 none 1 2 2 29785537 90811412THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daigle Leslie 808 Bayou Lane Thibodaux LA 70301 35 65 1 none 1 2 2 29785537 90811412THE PHYSICIAN'S ALLIANCE CORP (TPAC) Himel Eddie 808 Bayou Lane Thibodaux LA 70301 35 65 1 none 1 2 2 29785537 90811412THE PHYSICIAN'S ALLIANCE CORP (TPAC) Landry Steven 808 Bayou Lane Thibodaux LA 70301 37 74 1 none 1 2 2 29785537 90811412Eyecare Providers LLC dba Eyecare Associates Cerise Donald P. MD 900 N. Canal Thibodaux LA 70301 20 18 1 none 1 2 2 29826700 90811300SEAMAN CHARLES L OD Seaman Charles L. OD 907 Ridgefield Rd Thibodaux LA 70301 28 88 1 none 1 2 2 29791386 90827339THIBODAUX MEDICAL CLINIC Vanukuri Radha MD 931 Canal Blvd Thibodaux LA 70301 78 79 1 none 1 2 2 29791549 90820796THE PHYSICIAN'S ALLIANCE CORP (TPAC) Haight Edward 970 South Acadia Road Thibodaux LA 70301 20 13 1 none 1 2 2 29757979 90798338BREATHING CARE MEDICAL 101 D Talbot Ave Thibodeaux LA 70301 40 54 1 none 1 2 1 29797029 90822037THE PHYSICIAN'S ALLIANCE CORP (TPAC) Modisette James 605 N Acadia Road Suite 405 Thibodeaux LA 70301 20 2K 1 none 1 2 2 29778454 90804299THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vander Allen 605 N Acadia Road Suite 405 Thibodeaux LA 70301 20 2K 1 none 1 2 2 29778454 90804299THE PHYSICIAN'S ALLIANCE CORP (TPAC) Paine Jennifer 2729 Lee Drive Pierre Part LA 70339 35 65 1 none 1 2 2 29982895 91197394REDDY FAMILY MEDICAL CLINIC / Family Medical Clinic 3407 Hwy 70 Pierre Part LA 70339 79 94 1 none 1 2 1 29958870 91212691Reddy Family Medical Clinic Reddy Nagaratna MD 3407 Hwy 70 Pierre Part LA 70339 20 08 1 None 1 2 2 29958870 91212691TECHE ACTION CLINIC 3617 Hwy 70 South Pierre Part LA 70339 72 9L 1 none 1 2 1 29951147 91212684TECHE ACTION CLINIC Brignac Jeanenne C. 3617 Hwy 70 South Pierre Part LA 70339 20 08 1 None 1 2 1 29951147 91212684TECHE ACTION CLINIC Bustillo Mayra S. 3617 Hwy 70 South Pierre Part LA 70339 20 37 1 <=18 1 2 2 29951147 91212684TECHE ACTION CLINIC Clay Lori W. 3617 Hwy 70 South Pierre Part LA 70339 78 08 1 None 1 2 1 29951147 91212684TECHE ACTION CLINIC Clay Melissa W. 3617 Hwy 70 South Pierre Part LA 70339 78 08 1 None 1 2 2 29951147 91212684TECHE ACTION CLINIC Delgado Guillermo E. CRNA 3617 Hwy 70 South Pierre Part LA 70339 20 16 1 >=16 1 2 2 29951147 91212684TECHE ACTION CLINIC Eure Elizabeth C. 3617 Hwy 70 South Pierre Part LA 70339 78 08 1 None 1 2 2 29951147 91212684TECHE ACTION CLINIC Fabre Jennifer C. 3617 Hwy 70 South Pierre Part LA 70339 78 08 1 >=18 1 2 2 29951147 91212684TECHE ACTION CLINIC Gautam Chatshu 3617 Hwy 70 South Pierre Part LA 70339 20 08 1 None 1 2 1 29951147 91212684

Thibodaux Regional Medical Center


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

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TECHE ACTION CLINIC Gisclair Heather R. 3617 Hwy 70 South Pierre Part LA 70339 78 08 1 None 1 2 2 29951147 91212684TECHE ACTION CLINIC Hinds Trenton A. 3617 Hwy 70 South Pierre Part LA 70339 20 41 1 >=18 1 2 2 29951147 91212684TECHE ACTION CLINIC Miller Candice M. 3617 Hwy 70 South Pierre Part LA 70339 78 08 1 >=18 1 2 1 29951147 91212684TECHE ACTION CLINIC Millet Jennifer R. 3617 Hwy 70 South Pierre Part LA 70339 78 08 1 None 1 2 2 29951147 91212684TECHE ACTION CLINIC Molinere Stacey B. 3617 Hwy 70 South Pierre Part LA 70339 78 08 1 None 1 2 2 29951147 91212684TECHE ACTION CLINIC Morgan Cara M. 3617 Hwy 70 South Pierre Part LA 70339 20 08 1 None 1 2 1 29951147 91212684TECHE ACTION CLINIC Walker Patrick D. 3617 Hwy 70 South Pierre Part LA 70339 20 41 1 >=16 1 2 1 29951147 91212684TECHE ACTION CLINIC Wiltz Gary M. 3617 Hwy 70 South Pierre Part LA 70339 20 41 1 >=18 1 2 2 29951147 91212684Lady of the Sea Cut Off Clinic Berry Thomas MD 102 W 112th St Cut Off LA 70345 20 02 1 None 1 2 2 29478931 90320835Lady of the Sea Cut Off Clinic Birdsall Gary MD 102 W 112th St Cut Off LA 70345 20 08 1 None 1 2 2 29478931 90320835Lady of the Sea Cut Off Clinic Bossier Clayton NP 102 W 112th St Cut Off LA 70345 78 87 1 None 1 2 2 29478931 90320835Lady of the Sea Cut Off Clinic Gisclair Elizabeth NP 102 W 112th St Cut Off LA 70345 78 87 1 None 1 2 2 29478931 90320835Lady of the Sea Cut Off Clinic Lady of the Sea Cut Off Clinic 102 W 112th St Cut Off LA 70345 79 08 1 None 1 2 2 29478931 90320835Lady of the Sea Cut Off Clinic Rau Frederick MD 102 W 112th St Cut Off LA 70345 20 02 1 None 1 2 2 29478931 90320835Lady of the Sea Cut Off Clinic Schwab Donald MD 102 W 112th St Cut Off LA 70345 20 02 1 None 1 2 2 29478931 90320835Darby Chiasson OD Chiasson Darby OD 16140 W Main St Cut Off LA 70345 28 88 1 None 2 1 2 29471176 90314703Ochsner Clinic Cardwell James F. 186 West 134th St. Cut Off LA 70345 20 16 1 >=16 1 2 2 29456833 90307740Ochsner Clinic Faucheux Charles H. 186 West 134th St. Cut Off LA 70345 20 16 1 >=16 1 2 2 29456833 90307740Ochsner Clinic Miklic Margaret S. 186 West 134th St. Cut Off LA 70345 20 16 1 >=16 1 2 1 29456833 90307740Ochsner Clinic Morris Gregory P. 186 West 134th St. Cut Off LA 70345 20 16 1 >=16 1 2 1 29456833 90307740Ochsner Clinic Pitre Simone T. 186 West 134th St. Cut Off LA 70345 20 16 1 >=16 1 2 2 29456833 90307740Lady of The Sea Urology Clinic Benson Ralph MD 200 West 134 Place 3rd Floor Cut Off LA 70345 20 34 1 None 1 2 2 29455637 90312753Lady of The Sea Surgical Clinic Bonneval Monte MD 200 West 134 Place 3rd Floor Cut Off LA 70345 20 02 1 None 1 2 2 29455637 90312753Lady of the Sea Hospital Lady of the Sea Hospital 200 West 13th St Cut Off LA 70345 60 86 1 None 1 2 2 29513230 90328922REDDY FAMILY MEDICAL CLINIC / Family Medical Clinic Reddy Nagaratna MD 217 Railroad Ave. Donaldson LA 70346 20 08 1 None 1 2 1 30105015 90988062THE PHYSICIAN'S ALLIANCE CORP (TPAC) Paige Jerry 204 Clinic Drive Donaldsonville LA 70346 35 65 1 none 1 2 2 30089381 91003469Reddy Family Medical Clinic Reddy Nagaratna MD 217 Railroad Ave Donaldsonville LA 70346 20 08 1 None 1 2 2 30105015 90988062REDDY FAMILY MEDICAL CLINIC / Family Medical Clinic 217 Railroad Ave. Donaldsonville LA 70346 79 94 1 none 1 2 1 30105015 90988062PREVOST MEMORIAL HOSPITAL 301 Memorial Dr Donaldsonville LA 70346 60 86 1 none 1 2 2 30088843 91003406LAHIRI-MUNIR DEVJANI OD Lahiri-Munir Devjani APOC 309 Iberville St Donaldsonville LA 70346 28 88 1 none 1 2 1 30105744 90988519Belle Rose Chiropractic Clinic Brauwn Edward A. DC 7336 Hwy 1 South Donaldsonville LA 70346 30 35 1 none 1 2 1 30060721 91032225THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reddy Nagaratna 217 Railroad Ave Donaldsonvlle LA 70346 20 03 1 none 1 2 2 30105015 90988062CAJUN CHIROPRACTIC Elliott Richard DC 18598 W Main Galliano LA 70354 30 35 1 none 1 2 1 29417863 90285528Lady of the Sea Golden Meadow Clinic Folse Lenny NP 175 Washington St Golden Meadow LA 70357 78 87 1 None 1 2 2 29385241 90262541Lady of the Sea Golden Meadow Clinic Jackson John MD 175 Washington St Golden Meadow LA 70357 20 08 1 None 1 2 2 29385241 90262541IMAGING CENTER OF SOUTH LA 165 Frontage Rd., Ste. A Gray LA 70359 20 30 1 none 1 2 2 29690478 90782249Women's OB-Gyn Health & Wellness Andre Michelle M MD 1022 Belanger St Houma LA 70360 20 16 1 12-65 2 1 1 29595607 90712877THE PHYSICIAN'S ALLIANCE CORP (TPAC) Haydel Sarah 1026 School Street Houma LA 70360 20 07 1 none 1 2 2 29594949 90712948CARDIOSOM OF HOUMA 120 Progressive Blvd, Ste. 101 Houma LA 70360 40 54 1 none 1 2 2 29592410 90737895Family Vision Clinic Breaux Lawrence OD 126 Corporate Dr Houma LA 70360 28 88 1 None 2 1 1 29599423 90746898Cloutier Eyecare Cloutier Louis A OD 130 Enterprise Dr Houma LA 70360 28 88 1 None 2 1 1 29616116 90747763CLOUTIER EYECARE Cloutier Jr. Louis A. OD 130 Enterprise Dr Houma LA 70360 28 88 1 none 1 2 1 29616116 90747763THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bland Deron 1322 St. Charles Street Houma LA 70360 35 65 1 none 1 2 2 29585323 90745517THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thompson Amy 1322 St. Charles Street Houma LA 70360 37 74 1 none 1 2 2 29585323 90745517THE HEARING CENTER McCleary-Brooks Mary E. 205 Enterprise Ste C Houma LA 70360 34 64 1 none 1 2 1 29614820 90749545SYNERGY HOME CARE-SOUTHEASTERN REGION INC 216 Mystic Blvd Ste H Houma LA 70360 44 75 1 none 1 2 2 29590415 90746106AUDUBON PEDIATRICS LLC Harris Kimiyo MD 216 Mystic Blvd. Suite B Houma LA 70360 20 37 1 <=18 1 2 1 29590415 90746106AUDUBON PEDIATRICS LLC Kerley Nicole MD 216 Mystic Blvd. Suite B Houma LA 70360 20 37 1 <=18 1 2 1 29590415 90746106BROWN DIONNE V ST Brown Dionne 225 Corporate Dr Houma LA 70360 29 71 1 none 1 2 2 29599798 90750155AUDIBEL HEARING HEALTHCARE 251 Enterprise Dr Houma LA 70360 34 64 1 none 1 2 2 29614298 90750839


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

LINCARE INC 402 BARROW STREET HOUMA LA 70360 40 54 1 none 1 1 2 29595722 90719547THE PHYSICIAN'S ALLIANCE CORP (TPAC) Haydel Robert 4752 Hwy 311 Suite 108 Houma LA 70360 20 03 1 none 1 2 2 29600503 90760301SUGARLAND PEDIATRICS LLC Ber Leslie MD 5642 W. Main St Houma LA 70360 20 37 1 <=18 1 2 1 29641845 90761594ADAPTIVE PROSTHETICS & ORTHOT Leaber Robert J. CPO 808 Belanger St. Houma LA 70360 40 53 1 none 1 2 2 29596162 90717616TECHE ACTION CLINIC 809 West Tunnel Blvd. Houma LA 70360 72 9L 1 none 1 2 1 29590585 90731597TECHE ACTION CLINIC Brignac Jeanenne C. 809 West Tunnel Blvd. Houma LA 70360 20 08 1 None 1 2 1 29590585 90731597TECHE ACTION CLINIC Bustillo Mayra S. 809 West Tunnel Blvd. Houma LA 70360 20 37 1 <=18 1 2 2 29590585 90731597TECHE ACTION CLINIC Clay Lori W. 809 West Tunnel Blvd. Houma LA 70360 78 08 1 None 1 2 1 29590585 90731597TECHE ACTION CLINIC Clay Melissa W. 809 West Tunnel Blvd. Houma LA 70360 78 08 1 None 1 2 2 29590585 90731597TECHE ACTION CLINIC Delgado Guillermo E. CRNA 809 West Tunnel Blvd. Houma LA 70360 20 16 1 >=16 1 2 2 29590585 90731597TECHE ACTION CLINIC Eure Elizabeth C. 809 West Tunnel Blvd. Houma LA 70360 78 08 1 None 1 2 2 29590585 90731597TECHE ACTION CLINIC Fabre Jennifer C. 809 West Tunnel Blvd. Houma LA 70360 78 08 1 >=18 1 2 2 29590585 90731597TECHE ACTION CLINIC Gautam Chatshu 809 West Tunnel Blvd. Houma LA 70360 20 08 1 None 1 2 1 29590585 90731597TECHE ACTION CLINIC Gisclair Heather R. 809 West Tunnel Blvd. Houma LA 70360 78 08 1 None 1 2 2 29590585 90731597TECHE ACTION CLINIC Hinds Trenton A. 809 West Tunnel Blvd. Houma LA 70360 20 41 1 >=18 1 2 2 29590585 90731597TECHE ACTION CLINIC Miller Candice M. 809 West Tunnel Blvd. Houma LA 70360 78 08 1 >=18 1 2 1 29590585 90731597TECHE ACTION CLINIC Millet Jennifer R. 809 West Tunnel Blvd. Houma LA 70360 78 08 1 None 1 2 2 29590585 90731597TECHE ACTION CLINIC Molinere Stacey B. 809 West Tunnel Blvd. Houma LA 70360 78 08 1 None 1 2 2 29590585 90731597TECHE ACTION CLINIC Morgan Cara M. 809 West Tunnel Blvd. Houma LA 70360 20 08 1 None 1 2 1 29590585 90731597TECHE ACTION CLINIC Wiltz Gary M. 809 West Tunnel Blvd. Houma LA 70360 20 41 1 >=18 1 2 2 29590585 90731597Comprehensive Care Plus Ogden Moira L MD 8120 Main St Ste 403 Houma LA 70360 20 41 1 16-99 2 1 2 29598409 90715649THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gervais Donald 8120 Main Street Suite 400 Houma LA 70360 20 13 1 none 1 2 2 29598409 90715649MARY BIRD PERKINS CANCER CTR Bermudez Richard Scott 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 2 29598409 90715649MARY BIRD PERKINS CANCER CTR Boyer Cynthia I. 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 2 29598409 90715649MARY BIRD PERKINS CANCER CTR Fields Robert S. 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 2 29598409 90715649MARY BIRD PERKINS CANCER CTR Henkelmann Gregory C. 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 2 29598409 90715649MARY BIRD PERKINS CANCER CTR Johnson Sheldon A. 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 1 29598409 90715649MARY BIRD PERKINS CANCER CTR King, Jr. Maurice L. 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 1 29598409 90715649MARY BIRD PERKINS CANCER CTR Levine Renee A. 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 2 29598409 90715649MARY BIRD PERKINS CANCER CTR Lo Kenneth K. 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 2 29598409 90715649MARY BIRD PERKINS CANCER CTR Long Jeffrey P. 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 2 29598409 90715649MARY BIRD PERKINS CANCER CTR Sanders Mary Ella 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 2 29598409 90715649MARY BIRD PERKINS CANCER CTR Wood Charles G. 8120 Main Street, Ste. 102A Houma LA 70360 20 2J 1 >=18 1 2 2 29598409 90715649LABCORP 826 SCHOOL STREET HOUMA LA 70360 20 30 1 none 1 1 2 29595448 90717277Bourg Eye Clinic Bourg Otis J OD 832 Belanger St Houma LA 70360 28 88 1 None 2 1 1 29596120 90717258BLATT IRVING MMD Blatt Irving M. MD 855 Belanger St Suite 210 Houma LA 70360 20 04 1 none 1 2 2 29596305 90716486Gregory Maidoh MD Maidoh Gregory C MD 855 Belanger St Ste 201 Houma LA 70360 20 41 1 >=21 2 1 2 29596305 90716486Quest Diagnostics 855 Belanger Street Suite 105 Houma LA 70360 20 30 1 none 1 1 2 29596305 90716486THE PHYSICIAN'S ALLIANCE CORP (TPAC) Peltier Tracy 1321 Grand Caillou Road Houma LA 70363 35 65 1 none 1 2 2 29575883 90686881TECHE ACTION CLINIC 189 Mozart Drive Houma LA 70363 72 9L 1 none 1 2 1 29535896 90676024TECHE ACTION CLINIC Brignac Jeanenne C. 189 Mozart Drive Houma LA 70363 20 08 1 None 1 2 1 29535896 90676024TECHE ACTION CLINIC Bustillo Mayra S. 189 Mozart Drive Houma LA 70363 20 37 1 <=18 1 2 2 29535896 90676024TECHE ACTION CLINIC Clay Lori W. 189 Mozart Drive Houma LA 70363 78 08 1 None 1 2 1 29535896 90676024TECHE ACTION CLINIC Clay Melissa W. 189 Mozart Drive Houma LA 70363 78 08 1 None 1 2 2 29535896 90676024TECHE ACTION CLINIC Delgado Guillermo E. CRNA 189 Mozart Drive Houma LA 70363 20 16 1 >=16 1 2 2 29535896 90676024TECHE ACTION CLINIC Eure Elizabeth C. 189 Mozart Drive Houma LA 70363 78 08 1 None 1 2 2 29535896 90676024TECHE ACTION CLINIC Fabre Jennifer C. 189 Mozart Drive Houma LA 70363 78 08 1 >=18 1 2 2 29535896 90676024TECHE ACTION CLINIC Gautam Chatshu 189 Mozart Drive Houma LA 70363 20 08 1 None 1 2 1 29535896 90676024TECHE ACTION CLINIC Gisclair Heather R. 189 Mozart Drive Houma LA 70363 78 08 1 None 1 2 2 29535896 90676024TECHE ACTION CLINIC Hinds Trenton A. 189 Mozart Drive Houma LA 70363 20 41 1 >=18 1 2 2 29535896 90676024


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

TECHE ACTION CLINIC Miller Candice M. 189 Mozart Drive Houma LA 70363 78 08 1 >=18 1 2 1 29535896 90676024TECHE ACTION CLINIC Millet Jennifer R. 189 Mozart Drive Houma LA 70363 78 08 1 None 1 2 2 29535896 90676024TECHE ACTION CLINIC Molinere Stacey B. 189 Mozart Drive Houma LA 70363 78 08 1 None 1 2 2 29535896 90676024TECHE ACTION CLINIC Morgan Cara M. 189 Mozart Drive Houma LA 70363 20 08 1 None 1 2 1 29535896 90676024TECHE ACTION CLINIC Wiltz Gary M. 189 Mozart Drive Houma LA 70363 20 41 1 >=18 1 2 2 29535896 90676024THE PHYSICIAN'S ALLIANCE CORP (TPAC) Matherne David M. 1978 Industrial Avenue Houma LA 70363 19 10 1 none 1 2 2 29572289 90696430THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jain Neeraj 1978 Industrial Blvd. Houma LA 70363 20 06 1 none 1 2 2 29572289 90696430THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kishner Stephen 1978 Industrial Blvd. Houma LA 70363 35 65 1 none 1 2 2 29572289 90696430Grafton Dermatology Charbonnet Tamela MD 327 Bayou Gardens Blvd Houma LA 70364 20 07 1 None 1 2 2 29638589 90752173Grafton Dermatology Grafton Lee H MD 327 Bayou Gardens Blvd Houma LA 70364 20 07 1 None 1 2 2 29638589 90752173

Grafton Dermatology 327 Bayou Gardens Blvd Houma LA 70364 20 07 1 None 1 2 2 29638589 90752173LINCARE INC DBA PS HOMECA 6861 W PARK AVE HOUMA LA 70364 40 54 1 none 1 1 2 29610835 90743965LINCARE INC 6861 W. Park Avenue Houma LA 70364 20 29 1 none 1 2 1 29610835 90743965Lady of the Sea Larose Clinic Folse Lenny NP 13030 Hwy 308 LaRose LA 70373 78 08 1 None 1 2 2 29564752 90375938Lady of the Sea Larose Clinic Hodson Deanna NP 13030 Hwy 308 LaRose LA 70373 78 08 1 None 1 2 2 29564752 90375938Lady of the Sea Larose Clinic Pitre Camille MD 13030 Hwy 308 LaRose LA 70373 20 08 1 None 1 2 2 29564752 90375938DYNAMIC ORTHOTIC SERVICES, INC Margaglio Sam 1100 8th Street Morgan City LA 70380 40 53 1 none 1 2 2 29704324 91202201THE HEARING CENTER McCleary-Brooks Mary E. 1100 Victor II Blvd Morgan City LA 70380 34 64 1 none 1 2 1 29705623 91198965Robert P Blereau MD Blereau Robert MD 1122 Eighth St Morgan City LA 70380 20 08 1 None 2 1 1 29704505 91202295Robert P Blereau MD Blereau Robert MD 1122 Eighth St Morgan City LA 70380 20 16 1 >=16 Female 2 1 2 29704505 91202295TECHE REGIONAL MEDICAL CENTER 1125 Marquerite St Morgan City LA 70380 60 86 1 none 1 2 2 29708727 91200208LabCorp 1126 Marguarite St. MORGAN CITY LA 70380 20 30 1 none 1 1 2 29708644 91199907WESTBANK CARDIOLOGY, LLC Valdez Joseph Dean MD 1151 Marguerite Street Ste. 800 Morgan City LA 70380 20 06 1 none 1 2 1 29708878 91200148ONCOLOGICS INC DeLand M. Maitland MD 1201 David Drive Morgan City LA 70380 20 2J 1 none 1 2 2 29707307 91198031ONCOLOGICS INC Harwood Andrew R. MD 1201 David Drive Morgan City LA 70380 20 2J 1 none 1 2 1 29707307 91198031ONCOLOGICS INC Krawczyk Julian J. MD 1201 David Drive Morgan City LA 70380 20 2J 1 none 1 2 1 29707307 91198031ONCOLOGICS INC Prellop Perri B. MD 1201 David Drive Morgan City LA 70380 20 2J 1 none 1 2 1 29707307 91198031ONCOLOGICS INC Wilt Stephen R. MD 1201 David Drive Morgan City LA 70380 20 2J 1 none 1 2 1 29707307 91198031ONCOLOGICS INC Wortham Angela H. MD 1201 David Drive Morgan City LA 70380 20 2J 1 none 1 2 2 29707307 91198031MORICE III NATCHEZ J MD Morice Natchez J. MD 1216 Victor II Blvd Ste 100 Morgan City LA 70380 20 16 1 >=16 1 2 2 29700945 91195800NGOFA NWOSU O MD Ngofa Nwosu Osaro MD 1300 Lakewood Drive Ste A Morgan City LA 70380 20 02 1 none 1 2 2 29706554 91201471KIDD & ASSOCIATES, LLC Comeaux Keith M. OD 1301 Victor II Blvd., Ste. B Morgan City LA 70380 28 88 1 none 1 2 1 29700657 91194835KIDD & ASSOCIATES, LLC Kidd, III Milton B. OD 1301 Victor II Blvd., Ste. B Morgan City LA 70380 28 88 1 none 1 2 2 29700657 91194835BLATT IRVING MMD Blatt Irving M. MD 912 Marguerite St Morgan City LA 70380 20 04 1 none 1 2 2 29706134 91201459REDDY FAMILY MEDICAL CLINIC / Family Medical Clinic 154 Hwy 1008 Napoleonville LA 70390 79 94 1 none 1 2 2 29940616 91028564Reddy Family Medical Clinic Reddy Nagaratna MD 154 Hwy 1008 Napoleonville LA 70390 20 08 1 None 1 2 2 29940616 91028564Thibodaux Regional Network Developm Landry Keith MD 114 Highway 403 Paincourtville LA 70391 20 08 1 None 1 2 2 29999141 91056216Thibodaux Regional Network Developm Sherrod Rome MD 114 Highway 403 Paincourtville LA 70391 20 08 1 None 1 2 2 29999141 91056216THE PHYSICIAN'S ALLIANCE CORP (TPAC) Arcement Patrick 184 Highway 70 Spur Plattenville LA 70393 35 65 1 none 1 2 2 29997754 91026535THE PHYSICIAN'S ALLIANCE CORP (TPAC) Breaux Genea 184 Highway 70 Spur Plattenville LA 70393 35 65 1 none 1 2 2 29997754 91026535Ochsner Clinic Cardwell James F. 104 Acadia Drive Raceland LA 70394 20 16 1 >=16 1 2 2 29702294 90563490Ochsner Clinic Cunningham Robert J. 104 Acadia Drive Raceland LA 70394 20 2K 1 none 1 2 2 29702294 90563490Ochsner Clinic Faucheux Charles H. 104 Acadia Drive Raceland LA 70394 20 16 1 >=16 1 2 2 29702294 90563490Ochsner Clinic Miklic Margaret S. 104 Acadia Drive Raceland LA 70394 20 16 1 >=16 1 2 1 29702294 90563490Ochsner Clinic Morris Gregory P. 104 Acadia Drive Raceland LA 70394 20 16 1 >=16 1 2 1 29702294 90563490Ochsner Clinic Urrego Fernando A. 104 Acadia Drive Raceland LA 70394 20 29 1 none 1 2 1 29702294 90563490Ochsner Clinic Duplantis Andre' D. 111 Acadia Dr. Raceland LA 70394 20 08 1 None 1 2 2 29702262 90563923Ochsner Clinic Heidenreich Jack W. 111 Acadia Dr. Raceland LA 70394 20 08 1 None 1 2 2 29702262 90563923Ochsner Clinic Marcello Michael J. 111 Acadia Dr. Raceland LA 70394 20 08 1 None 1 2 2 29702262 90563923

Grafton Dermatology


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Ochsner Clinic Trant Elizabeth 111 Acadia Drive Raceland LA 70394 78 08 1 None 1 2 2 29702262 90563923THE PHYSICIAN'S ALLIANCE CORP (TPAC) Breaux Freddie 115 Johnny Dufrene Drive Raceland LA 70394 35 65 1 none 1 2 2 29694108 90553502THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hotard Kyle 115 Johnny Dufrene Drive Raceland LA 70394 37 74 1 none 1 2 2 29694108 90553502THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jongbloets Rutgerus 115 Johnny Dufrene Drive Raceland LA 70394 35 65 1 none 1 2 2 29694108 90553502THE PHYSICIAN'S ALLIANCE CORP (TPAC) Piacun Christopher 115 Johnny Dufrene Drive Raceland LA 70394 35 65 1 none 1 2 2 29694108 90553502THE PHYSICIAN'S ALLIANCE CORP (TPAC) Santiny Gino 115 Johnny Dufrene Drive Raceland LA 70394 37 74 1 none 1 2 2 29694108 90553502Ochsner Clinic Abi-Samra Freddy M. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Bernal Jose Alberto 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Collins Tyrone J. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Cunningham Robert J. 4608 Highway 1 Raceland LA 70394 20 2K 1 none 1 2 2 29702534 90562582Ochsner Clinic Delaney, Jr. Patrick A. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Dinshaw Homeyar K. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Elizardi David J. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Gilliland Yvonne E. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Grise' Mark A. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Huddleston Jamie B. 4608 Highway 1 Raceland LA 70394 20 13 1 none 1 2 2 29702534 90562582Ochsner Clinic Jenkins James S. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Khatib Sammy 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Lavie, Jr. Carl J. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Lecce Michael D. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Lessig Paul M. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic McMullan, Jr. Paul W. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Mello Dennis M. 4608 Highway 1 Raceland LA 70394 20 1D 1 none 1 2 1 29702534 90562582Ochsner Clinic Milani Richard V. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Mulder Theodorus J. 4608 Highway 1 Raceland LA 70394 20 1D 1 none 1 2 1 29702534 90562582Ochsner Clinic Nawaz Mohammed Q. 4608 Highway 1 Raceland LA 70394 20 41 1 >=18 1 2 2 29702534 90562582Ochsner Clinic Nelson Twakor Onajefe S. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Patel Rajan A. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Pitre Simone T. 4608 Highway 1 Raceland LA 70394 20 16 1 >=16 1 2 2 29702534 90562582Ochsner Clinic Reilly John P. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Rich Gary M. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Shah Sangeeta B. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic White Christopher J. 4608 Highway 1 Raceland LA 70394 20 06 1 none 1 2 2 29702534 90562582Ochsner Clinic Daigle Linsey 4608 Highway 1, Raceland, LA 70394 Raceland LA 70394 78 79 1 >=18 1 2 2 29743817 90612171Ochsner Clinic Keller Kaycee 4608 Highway 1, Raceland, LA 70394 Raceland LA 70394 91 05 1 none 1 2 2 29743817 90612171Ochsner Clinic Torres Angelique 4608 Highway 1, Raceland, LA 70394 Raceland LA 70394 78 79 1 >=18 1 2 2 29743817 90612171Ochsner St. Anne General Hospital 4608 Hwy 1 Raceland LA 70394 60 86 1 none 1 2 2 29702534 90562582Rozalynde Randolph MD Randolph Rozalynde A MD 4803 Hwy 1 Raceland LA 70394 20 37 1 <=18 2 1 1 29691300 90550000Eyecare Providers LLC dba Eyecare Associates Landry Ronald A. MD 5138 Hwy One Raceland LA 70394 20 18 1 none 1 2 2 29662800 90539300THOMAS H WINGO JR DDS 1008 WEST THOMAS STREET HAMMOND LA 70401 32 48 1 none 1 1 2 30501841 90471546National Rehab Equipment Inc. Gallagher Jason 109 S. Café Avenue Hammond LA 70401 40 54 1 none 1 2 2 30540282 90494931Eyecare Providers LLC dba Eyecare Associates Sumich Leni T. MD 110 Robert Street Hammond LA 70401 20 18 1 none 1 2 2 30506110 90461812HAMMOND EYE CLINIC LLC Hollimon Jerry A. OD 110 W. Robert St. Hammond LA 70401 28 88 1 none 1 2 2 30506110 90461812HAMMOND EYE CLINIC LLC Pradillo Alan R. OD 110 W. Robert St. Hammond LA 70401 28 88 1 none 1 2 1 30506110 90461812THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lewis Dorothy 120 N Cate Street Hammond LA 70401 20 02 1 none 1 2 2 30504395 90460899THE PHYSICIAN'S ALLIANCE CORP (TPAC) Liner F Jefferson 120 N Cate Street Hammond LA 70401 20 02 1 none 1 2 2 30504395 90460899CHILDREN FIRST KID MED 1828 W. Thomas Hammond LA 70401 79 94 1 none 1 2 2 30501055 90479942CHILDREN FIRST KID MED Lee Pat 1828 W. Thomas Hammond LA 70401 20 37 1 <=18 1 2 2 30501055 90479942THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bean Brandon 1905 West Thomas Street Suite D #356 Hammond LA 70401 20 2K 1 none 1 2 2 30500779 90480147THE PHYSICIAN'S ALLIANCE CORP (TPAC) Granger Wendy NP 1905 West Thomas Street Suite D #356 Hammond LA 70401 78 79 1 >=18 1 2 2 30500779 90480147


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

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Postal Code

Advanced Spinal Care Miller Jay DC 2790 W Church St Ste 4 Hammond LA 70401 30 35 1 None 2 1 2 30504671 90492874MILLER JAY M DC Miller Jay M. 2790 W. Church St Ste 4 Hammond LA 70401 30 35 1 none 1 2 1 30504671 90492874THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chiasson Brett 1000 J. W. Davis Drive Hammond LA 70403 20 20 1 none 1 2 2 30486529 90469953Ochsner Clinic DiCorte Charles J. 1000 Ochsner Blvd. Hammond LA 70403 20 33 1 none 1 2 2 30505102 90394323ANTHON CHIROPRATIC CARE Anthon, Jr. George DC 105 S. Cherry St. Hammond LA 70403 30 35 1 none 1 2 1 30504516 90458356

MURRAY JR WINSTON LMD 109 W MINNESOTA PK PLACE/STE 3 HAMMOND LA 70403 41 1 None 1 2 2 30484746 90455385WINSTON MURRAY JR Murray, Jr. Winston L. MD 109 W. Minnesota Pk Pl #3 Hammond LA 70403 20 41 1 >=18 1 2 1 30484746 90455385COASTAL ORTHOTICS & PROSTHETICS LLC Bass, III J. Gordan 1100 CM Eagan Drive Suite 100 Hammond LA 70403 40 53 1 none 1 2 2 30501209 90454141COASTAL ORTHOTICS & PROSTHETICS LLC Northey Sean W. 1100 CM Eagan Drive Sute 100 Hammond LA 70403 40 53 1 none 1 2 2 30500038 90449180SYNERGY HOME CARE-NORTHSHORE REGION 1305 Derek Dr Ste 1 & 2 Hammond LA 70403 44 75 1 none 1 2 2 30487349 90484662Quest Diagnostics 1445 South Morrison Boulevard Hammond LA 70403 20 30 1 none 1 1 2 30486114 90482481THE PHYSICIAN'S ALLIANCE CORP (TPAC) Henchy Frank 150709 Professional Plaza Hammond LA 70403 20 07 1 none 1 2 1 30488974 90448206Audiology Associates of Hammond Ducombs Sherry C AUD 15706 Professional Plaza Hammond LA 70403 34 64 1 None 2 1 1 30474065 90460822LUIS R FRANCO MD APMC Franco Luis R. MD 15717 Belle Dr Hammond LA 70403 35 65 1 none 1 2 2 30462905 90459230MARY BIRD PERKINS CANCER CTR Bermudez Richard Scott 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 2 30466173 90460107MARY BIRD PERKINS CANCER CTR Boyer Cynthia I. 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 2 30466173 90460107MARY BIRD PERKINS CANCER CTR Fields Robert S. 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 2 30466173 90460107MARY BIRD PERKINS CANCER CTR Henkelmann Gregory C. 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 2 30466173 90460107MARY BIRD PERKINS CANCER CTR Johnson Sheldon A. 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 1 30466173 90460107MARY BIRD PERKINS CANCER CTR King, Jr. Maurice L. 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 1 30466173 90460107MARY BIRD PERKINS CANCER CTR Levine Renee A. 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 2 30466173 90460107MARY BIRD PERKINS CANCER CTR Lo Kenneth K. 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 2 30466173 90460107MARY BIRD PERKINS CANCER CTR Long Jeffrey P. 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 2 30466173 90460107MARY BIRD PERKINS CANCER CTR Sanders Mary Ella 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 2 30466173 90460107MARY BIRD PERKINS CANCER CTR Wood Charles G. 15728 Paul Vega MD Drive Hammond LA 70403 20 2J 1 >=18 1 2 2 30466173 90460107THE PHYSICIAN'S ALLIANCE CORP (TPAC) Linarello Daniel A. 15742 Medical Arts Plaza Hammond LA 70403 20 02 1 none 1 2 2 30464556 90458764THE PHYSICIAN'S ALLIANCE CORP (TPAC) Winkler Margaret 15744 Medical Arts Plaza Hammond LA 70403 20 41 1 >=18 1 2 1 30464556 90458724THE PHYSICIAN'S ALLIANCE CORP (TPAC) Agena Gary 15748 Medical Arts Plaza Hammond LA 70403 20 16 1 >=16 1 2 1 30464560 90458636THE PHYSICIAN'S ALLIANCE CORP (TPAC) Beacham William 15748 Medical Arts Plaza Hammond LA 70403 20 16 1 >=16 1 2 1 30464560 90458636THE PHYSICIAN'S ALLIANCE CORP (TPAC) Black William 15748 Medical Arts Plaza Hammond LA 70403 20 16 1 >=16 1 2 1 30464560 90458636THE PHYSICIAN'S ALLIANCE CORP (TPAC) Shuman Deborah 15748 Medical Arts Plaza Hammond LA 70403 20 16 1 >=16 1 2 1 30464560 90458636SPADY MALIK C MD Spady Malik C. MD 15752 Medical Arts Plaza Ste. 100 Hammond LA 70403 20 2M 1 >=18 1 2 1 30464564 90458556THE PHYSICIAN'S ALLIANCE CORP (TPAC) Summers Lori 15770 Paul Vega Dr Suite206 Hammond LA 70403 20 14 1 none 1 2 2 30466198 90459446THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kidd Robert 15770 Paul Vega Drive #200 Hammond LA 70403 20 34 1 none 1 2 2 30466198 90459446THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mussart Pervez 15784 Medical Arts Plaza Suite A Hammond LA 70403 20 13 1 none 1 2 1 30464656 90457637DAVID L. SCHNEIDER, MD APMC Schneider David L. MD 15825 Professional Plaza Suite A Hammond LA 70403 20 03 1 none 1 2 1 30474583 90459690THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rab Syed T. 16026 Doctors Blvd Hammond LA 70403 20 41 1 >=18 1 2 1 30466700 90453700Ochsner Clinic Mendoza Douglas K. 16045 Doctors Blvd. Hammond LA 70403 20 06 1 none 1 2 1 30466700 90453700Ochsner Clinic Mikdadi Ghiath M. 16045 Doctors Blvd. Hammond LA 70403 20 06 1 none 1 2 1 30466700 90453700THE PHYSICIAN'S ALLIANCE CORP (TPAC) Booth Dennis J. 16061 Doctors Blvd Suite B Hammond LA 70403 20 10 1 none 1 2 2 30466700 90453700THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gensler Lawrence 16061 Doctors Blvd Suite B Hammond LA 70403 20 10 1 none 1 2 2 30466700 90453700THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mula Gregory 16061 Doctors Blvd Suite B Hammond LA 70403 20 10 1 none 1 2 1 30466700 90453700THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reina Jason 16061 Doctors Blvd Suite B Hammond LA 70403 20 10 1 none 1 2 1 30466700 90453700THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wardlaw Russell 16061 Doctors Blvd Suite B Hammond LA 70403 20 10 1 none 1 2 1 30466700 90453700KIDNEY & HYPERTENSION ASSOCIATES Bean Brandon K. 16081 Doctors Blvd Suite B Hammond LA 70403 20 2K 1 >=18 1 2 2 30466700 90453700KIDNEY & HYPERTENSION ASSOCIATES Kapoor Mohit MD 16081 Doctors Blvd Hammond LA 70403 20 2K 1 >=18 1 2 2 30466700 90453700KIDNEY & HYPERTENSION ASSOCIATES Powers David R. MD 16081 Doctors Blvd Suite B Hammond LA 70403 20 2K 1 >=18 1 2 2 30466700 90453700KIDNEY & HYPERTENSION ASSOCIATES Pratt Wendy A. FNP 16081 Doctors Blvd Hammond LA 70403 78 79 1 >=18 1 2 2 30466700 90453700EYE PHYSICIANS & SURGEONS INC Fajoni Michael L. MD 1615 S.W. Railroad Ave Hammond LA 70403 20 18 1 >=18 1 2 2 30487171 90456551EYE PHYSICIANS & SURGEONS INC Fivgas George D. MD 1615 S.W. Railroad Ave Hammond LA 70403 20 18 1 none 1 2 2 30487171 90456551


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New Patient

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EYE PHYSICIANS & SURGEONS INC Rhodes Annette M. MD 1615 S.W. Railroad Ave Hammond LA 70403 20 18 1 none 1 2 2 30487171 90456551BOND EYE CLINIC INC Bessent Richard O. MD 1705 S Morrison Blvd Hammond LA 70403 20 18 1 none 1 2 2 30483724 90482457BOND EYE CLINIC INC Nelson Scott K. MD 1705 S Morrison Blvd Hammond LA 70403 20 18 1 none 1 2 2 30483724 90482457BOND EYE CLINIC INC Noguchi Barbara A. MD 1705 S Morrison Blvd Hammond LA 70403 20 18 1 none 1 2 2 30483724 90482457BOND EYE CLINIC INC Paddock Adam OD 1705 S Morrison Blvd Hammond LA 70403 28 88 1 none 1 2 1 30483724 90482457BOND EYE CLINIC INC Pradillo Alan OD 1705 S Morrison Blvd Hammond LA 70403 28 88 1 none 1 2 1 30483724 90482457BOND EYE CLINIC INC Richardson Daphne L. OD 1705 S Morrison Blvd Hammond LA 70403 28 88 1 none 1 2 1 30483724 90482457BOND EYE CLINIC INC Wroten Sarah F. OD 1705 S Morrison Blvd Hammond LA 70403 28 88 1 none 1 2 2 30483724 90482457BOND EYE CLINIC INC Bond R. Hunter OD 1705 S. Morrison Blvd Hammond LA 70403 28 88 1 none 1 2 1 30483724 90482457BOND EYE CLINIC INC Wroten Christopher W. OD 1705 S. Morrison Blvd Hammond LA 70403 28 88 1 none 1 2 1 30483724 90482457NORTHSHORE EYE ASSOCIATES LLC 17170 S. I-12 Service Rd Hammond LA 70403 28 88 1 none 1 2 2 30478396 90445795NORTHSHORE EYE ASSOCIATES LLC Griener Eric D. MD 17170 S. I-12 Service Rd Hammond LA 70403 20 18 1 none 1 2 1 30478396 90445795NORTHSHORE EYE ASSOCIATES LLC Langlow Edward P. MD 17170 S. I-12 Service Rd Hammond LA 70403 20 18 1 none 1 2 2 30478396 90445795NORTHSHORE EYE ASSOCIATES LLC Leger Brandy L. OD 17170 S. I-12 Service Rd Hammond LA 70403 28 88 1 none 1 2 2 30478396 90445795LA OPTICAL LLC 17170 S. I-12 Service Rd. Hammond LA 70403 75 88 1 none 1 2 2 30478396 90445795Tiger Vision, LLC Haley Henry MD 1801 C M Fagan Dr Hammond LA 70403 20 18 1 none 1 2 2 30481653 90480804Tiger Vision, LLC Hendricks Sean MD 1801 C M Fagan Dr Ste 6 Hammond LA 70403 20 18 1 none 1 2 2 30481653 90480804Tiger Vision, LLC Thomas Charles OD 1801 CM Fagan Ste 6 Hammond LA 70403 28 88 1 none 1 2 1 30481653 90480804HANGER PROSTHETICS AND ORTHOTICS 1801 CM Fagan Dr. Ste 4 Hammond LA 70403 40 53 1 none 1 2 1 30481653 90480804HANGER PROSTHETICS AND ORTHOTICS 1801 CM Fagan Drive, Suite 4 Hammond LA 70403 40 53 1 none 1 2 1 30481653 90480804Hanger Prosthetics & Orthotics Inc. 1801 Cn Fagan Drive Suite 4 Hammond LA 70403 40 53 1 none 1 1 2 30481653 90480804PRECISION OPTICAL OF HAMMOND INC Thomas Charles E. OD 1801 Fagan Dr Ste 7 Hammond LA 70403 28 88 1 none 1 2 1 30483799 90388494THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allen John 2101 Robin Ave Suite 1 Hammond LA 70403 32 48 1 none 1 2 1 30485428 90483799THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kidd, III Ralph 2101 Robin Ave Suite 1 Hammond LA 70403 20 34 1 none 1 2 1 30485428 90483799THE PHYSICIAN'S ALLIANCE CORP (TPAC) Roig Randolph 2101 Robin Ave Suite 3 Hammond LA 70403 35 65 1 none 1 2 2 30485428 90483799THE PHYSICIAN'S ALLIANCE CORP (TPAC) Busby Cheryl 2204 Robin Avenue Hammond LA 70403 35 65 1 none 1 2 2 30485163 90485025THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kovar Marilyn 2204 Robin Avenue Hammond LA 70403 35 65 1 none 1 2 2 30485163 90485025THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leingang Brian 2204 Robin Avenue Hammond LA 70403 37 74 1 none 1 2 2 30485163 90485025THE PHYSICIAN'S ALLIANCE CORP (TPAC) Starring Deborah 2204 Robin Avenue Hammond LA 70403 35 65 1 none 1 2 2 30485163 90485025AUDIBEL HEARING HEALTHCARE 307 W Minnesota Pk Ste 4 Hammond LA 70403 34 64 1 none 1 2 2 30484753 90459138Ochsner Clinic Antillon Mainor R. 41676 Veterans Avenue Hammond LA 70403 20 10 1 none 1 2 2 30460904 90457173Ochsner Clinic Bizette Greg A. 41676 Veterans Avenue Hammond LA 70403 20 2H 1 none 1 2 2 30460904 90457173Ochsner Clinic Blessey Peter B. 41676 Veterans Avenue Hammond LA 70403 20 20 1 none 1 2 2 30460904 90457173Ochsner Clinic Boinapally Vaidehi 41676 Veterans Avenue Hammond LA 70403 20 41 1 >=18 1 2 2 30460904 90457173Ochsner Clinic Bowie R. Earl 41676 Veterans Avenue Hammond LA 70403 20 04 1 none 1 2 2 30460904 90457173Ochsner Clinic Charbonnet Nicole M. 41676 Veterans Avenue Hammond LA 70403 20 16 1 >=16 1 2 2 30460904 90457173Ochsner Clinic Colegrove Jeffery A. 41676 Veterans Avenue Hammond LA 70403 28 88 1 none 1 2 2 30460904 90457173Ochsner Clinic Devraj Timothy 41676 Veterans Avenue Hammond LA 70403 20 20 1 none 1 2 2 30460904 90457173Ochsner Clinic Dipp Susana L. 41676 Veterans Avenue Hammond LA 70403 20 2E 1 none 1 2 2 30460904 90457173Ochsner Clinic Dunn Michael A. 41676 Veterans Avenue Hammond LA 70403 20 08 1 None 1 2 2 30460904 90457173Ochsner Clinic Eckholdt Gregory J. 41676 Veterans Avenue Hammond LA 70403 20 33 1 none 1 2 1 30460904 90457173Ochsner Clinic Fabrega Ruben D. 41676 Veterans Avenue Hammond LA 70403 20 2H 1 none 1 2 2 30460904 90457173Ochsner Clinic Ferrier Janine M. 41676 Veterans Avenue Hammond LA 70403 20 41 1 >=18 1 2 2 30460904 90457173Ochsner Clinic Gilliland Yvonne E. 41676 Veterans Avenue Hammond LA 70403 20 06 1 none 1 2 2 30460904 90457173Ochsner Clinic Gillispie Veronica G. 41676 Veterans Avenue Hammond LA 70403 20 16 1 >=16 1 2 1 30460904 90457173Ochsner Clinic Hajjar Joseph D. 41676 Veterans Avenue Hammond LA 70403 20 30 1 none 1 2 2 30460904 90457173Ochsner Clinic Hake Daniel H. 41676 Veterans Avenue Hammond LA 70403 32 48 1 none 1 2 2 30460904 90457173Ochsner Clinic Hassett Cathryn C. 41676 Veterans Avenue Hammond LA 70403 20 03 1 none 1 2 2 30460904 90457173Ochsner Clinic Holt Sarah W. 41676 Veterans Avenue Hammond LA 70403 19 08 1 None 1 2 2 30460904 90457173Ochsner Clinic Hudspeth Ted J. 41676 Veterans Avenue Hammond LA 70403 20 08 1 None 1 2 2 30460904 90457173


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Joseph, Jr. Gerald F. 41676 Veterans Avenue Hammond LA 70403 20 16 1 >=16 1 2 2 30460904 90457173Ochsner Clinic Kaliebe Olga 41676 Veterans Avenue Hammond LA 70403 20 2E 1 none 1 2 2 30460904 90457173Ochsner Clinic Lavie, Jr. Carl J. 41676 Veterans Avenue Hammond LA 70403 20 06 1 none 1 2 2 30460904 90457173Ochsner Clinic Loftfield Katherine M. 41676 Veterans Avenue Hammond LA 70403 20 18 1 none 1 2 2 30460904 90457173Ochsner Clinic Mazzulla Anthony D. 41676 Veterans Avenue Hammond LA 70403 20 18 1 none 1 2 2 30460904 90457173Ochsner Clinic McBurney Donald B. 41676 Veterans Avenue Hammond LA 70403 20 30 1 none 1 2 2 30460904 90457173Ochsner Clinic Mena Jose 41676 Veterans Avenue Hammond LA 70403 20 33 1 none 1 2 2 30460904 90457173Ochsner Clinic Mokry Daniel P. 41676 Veterans Avenue Hammond LA 70403 20 16 1 >=16 1 2 1 30460904 90457173Ochsner Clinic Morris, III George B. 41676 Veterans Avenue Hammond LA 70403 20 16 1 >=16 1 2 1 30460904 90457173Ochsner Clinic Nelson Brian K. 41676 Veterans Avenue Hammond LA 70403 28 88 1 none 1 2 2 30460904 90457173Ochsner Clinic Newman Chevies W. 41676 Veterans Avenue Hammond LA 70403 20 16 1 >=16 1 2 1 30460904 90457173Ochsner Clinic Ortenberg Joseph PT 41676 Veterans Avenue Hammond LA 70403 20 34 1 none 1 2 1 30460904 90457173Ochsner Clinic Palo Matti W. 41676 Veterans Avenue Hammond LA 70403 20 20 1 none 1 2 2 30460904 90457173Ochsner Clinic Perry Anthony G. 41676 Veterans Avenue Hammond LA 70403 32 48 1 none 1 2 2 30460904 90457173Ochsner Clinic Ray Marilyn C. 41676 Veterans Avenue Hammond LA 70403 20 07 1 none 1 2 2 30460904 90457173Ochsner Clinic Restrepo Robert 41676 Veterans Avenue Hammond LA 70403 20 30 1 none 1 2 2 30460904 90457173Ochsner Clinic Robinson, III Herbert G. 41676 Veterans Avenue Hammond LA 70403 20 08 1 None 1 2 2 30460904 90457173Ochsner Clinic Rowan Darren M. 41676 Veterans Avenue Hammond LA 70403 20 02 1 none 1 2 2 30460904 90457173Ochsner Clinic Sparks Gerald J. 41676 Veterans Avenue Hammond LA 70403 20 08 1 None 1 2 2 30460904 90457173Ochsner Clinic St. Pierre Jerry J. 41676 Veterans Avenue Hammond LA 70403 20 16 1 >=16 1 2 2 30460904 90457173Ochsner Clinic Vasireddy Sreekanth 41676 Veterans Avenue Hammond LA 70403 20 2H 1 none 1 2 2 30460904 90457173Ochsner Clinic Winstead Nathaniel S. 41676 Veterans Avenue Hammond LA 70403 20 10 1 none 1 2 2 30460904 90457173Ochsner Clinic Wolf Gary J. 41676 Veterans Avenue Hammond LA 70403 20 02 1 none 1 2 2 30460904 90457173Ochsner Clinic Woo Howard H. 41676 Veterans Avenue Hammond LA 70403 20 34 1 none 1 2 2 30460904 90457173LIFECARE MEDICAL INC 42014 Veterans Avenue Hammond LA 70403 40 54 1 none 1 2 2 30467574 90457203LA Heart Center Arena Frank J MD 42078 Veterans Ave Ste D Hammond LA 70403 20 06 1 >=18 2 1 2 30468883 90457152LA Heart Center Hickey Keith G MD 42078 Veterans Ave Ste D Hammond LA 70403 20 06 1 >=18 2 1 2 30468883 90457152LA Heart Center Stein Jeffrey J NP 42078 Veterans Ave Ste B Hammond LA 70403 78 87 1 >=18 2 1 2 30468883 90457152LA HEART CENTER Arena Frank MD 42078 Veterans Blvd. Suite D Hammond LA 70403 20 06 1 none 1 2 2 30468883 90457152LA HEART CENTER Bernstein Marc MD 42078 Veterans Blvd. Suite D Hammond LA 70403 20 06 1 none 1 2 2 30468883 90457152LA HEART CENTER Hickey Keith MD 42078 Veterans Blvd. Suite D Hammond LA 70403 20 06 1 none 1 2 2 30468883 90457152LA HEART CENTER Iteld Bruce MD 42078 Veterans Blvd. Suite D Hammond LA 70403 20 06 1 none 1 2 1 30468883 90457152LA HEART CENTER Sharma Sushant MD 42078 Veterans Blvd. Suite D Hammond LA 70403 20 06 1 none 1 2 2 30468883 90457152LA HEART CENTER Silverstein Jay MD 42078 Veterans Blvd. Suite D Hammond LA 70403 20 06 1 none 1 2 2 30468883 90457152LA HEART CENTER Stein Jeffrey NP 42078 Veterans Blvd. Suite D Hammond LA 70403 78 79 1 >=18 1 2 2 30468883 90457152CHILDREN'S INTERNATIONAL Claycomb Stephen MD 42124 Veterans Ave., Ste. A Hammond LA 70403 20 37 1 <=18 1 2 1 30469725 90457111CHILDREN'S INTERNATIONAL Cohen Irwin MD 42124 Veterans Ave., Ste. A Hammond LA 70403 20 37 1 <=18 1 2 1 30469725 90457111CHILDREN'S INTERNATIONAL Hernandez Eduardo MD 42124 Veterans Ave., Ste. A Hammond LA 70403 20 29 1 none 1 2 1 30469725 90457111CHILDREN'S INTERNATIONAL Jeansonne Cornel MD 42124 Veterans Ave., Ste. A Hammond LA 70403 20 37 1 <=18 1 2 1 30469725 90457111CHILDREN'S INTERNATIONAL Moody Kristi NP 42124 Veterans Ave., Ste. A Hammond LA 70403 78 08 1 >=18 1 2 1 30469725 90457111CHILDREN'S INTERNATIONAL Narumanchi Janani MD 42124 Veterans Ave., Ste. A Hammond LA 70403 20 37 1 <=18 1 2 1 30469725 90457111CHILDREN'S INTERNATIONAL Plauche Andrea NP 42124 Veterans Ave., Ste. A Hammond LA 70403 78 79 1 >=18 1 2 2 30469725 90457111CHILDREN'S INTERNATIONAL Pouw I.S. Victor MD 42124 Veterans Ave., Ste. A Hammond LA 70403 20 2E 1 none 1 2 1 30469725 90457111CHILDREN'S INTERNATIONAL Wilson Ella NP 42124 Veterans Ave., Ste. A Hammond LA 70403 78 08 1 >=18 1 2 1 30469725 90457111PEDIATRIC CARDIOLOGY ASSOCIATES Brumund Michael R. MD 42205 Veterans Ave Hammond LA 70403 20 1D 1 none 1 2 1 30471487 90457387PEDIATRIC CARDIOLOGY ASSOCIATES Crapanzano Michael S. MD 42205 Veterans Ave Hammond LA 70403 20 1D 1 none 1 2 1 30471487 90457387PEDIATRIC CARDIOLOGY ASSOCIATES Hixon Rufus L. MD 42205 Veterans Ave Hammond LA 70403 20 1D 1 none 1 2 1 30471487 90457387THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 42205 Veterans Ave Hammond LA 70403 20 03 1 none 1 2 2 30471487 90457387THE PHYSICIAN'S ALLIANCE CORP (TPAC) Berry, III Markham C. 42333 Deluxe Plaza Suite 7 Hammond LA 70403 20 16 1 >=16 1 2 2 30471900 90473900THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mooney Timothy 42333 Deluxe Plaza Suite 7 Hammond LA 70403 20 16 1 >=16 1 2 1 30471900 90473900


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dileo Joseph 42388 Pelican Profesional Pk Hammond LA 70403 32 48 1 none 1 2 1 30464600 90457900THE PHYSICIAN'S ALLIANCE CORP (TPAC) St Amant Katherine 42388 Pelican Profesional Pk Hammond LA 70403 20 41 1 >=18 1 2 2 30464600 90457900THE PHYSICIAN'S ALLIANCE CORP (TPAC) Drummond Darren 42388 Pelican Professional Par Hammond LA 70403 20 41 1 >=18 1 2 2 30464600 90457900THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jones Jasper 42388 Pelican Professional Par Hammond LA 70403 20 41 1 >=18 1 2 2 30464600 90457900THE PHYSICIAN'S ALLIANCE CORP (TPAC) Steven Nicholas 42388 Pelican Professional Par Hammond LA 70403 20 41 1 >=18 1 2 2 30464600 90457900THE PHYSICIAN'S ALLIANCE CORP (TPAC) Zadeh Sousan 42388 Pelican Professional Par Hammond LA 70403 19 2K 1 none 1 2 2 30464600 90457900THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mellin Nancy 42401 Pelican Professional Par Hammond LA 70403 20 04 1 none 1 2 1 30464600 90457900THE PHYSICIAN'S ALLIANCE CORP (TPAC) Suarez Bonadelvert 42421 Professional Park Hammond LA 70403 20 34 1 none 1 2 1 30488013 90481388STEPHEN E WARREN LLC Cook Kristi W. 800 C.M. Fagan Drive Hammond LA 70403 28 88 1 none 1 2 2 30482609 90464904STEPHEN E WARREN LLC Warren Stephen E. 800 C.M. Fagan Drive Hammond LA 70403 28 88 1 none 1 2 1 30482609 90464904Tangi Vision Outlet Cook Kristina W OD 800 CM Fagan Dr Ste F Hammond LA 70403 28 88 1 None 2 1 2 30482609 90464904Ochsner Clinic Abel Genesa Garofalo 41676 Veterans Avenue Hamond LA 70403 20 08 1 None 1 2 2 30460904 90457173THE PHYSICIAN'S ALLIANCE CORP (TPAC) Manning Alan P.o. Box 1515 Hammond LA 70404 20 02 1 none 1 2 2 30504060 90461504Ochsner Clinic Palmisano Vernon K. 22070 Highway 59 Suite C Abita Springs LA 70420 20 08 1 None 1 2 2 30478183 90038346COMPLETE PATIENT SERVICES 70161 Hwy 59 Ste C Abita Springs LA 70420 40 54 1 none 1 2 2 30455954 90040854Ochsner Clinic Buras Elizabeth 22070 Highway 59 Albita Springs LA 70420 78 08 1 None 1 2 2 30478183 90038346Ochsner Clinic Petroff Glenda 22070 Highway 59 Albita Springs LA 70420 78 08 1 None 1 2 2 30478183 90038346KIDNEY & HYPERTENSION ASSOCIATES Bean Brandon K. 110 North First Street Amite LA 70422 20 2K 1 >=18 1 2 2 30726886 90510387KIDNEY & HYPERTENSION ASSOCIATES Kapoor Mohit MD 110 North First Street Amite LA 70422 20 2K 1 >=18 1 2 2 30726886 90510387KIDNEY & HYPERTENSION ASSOCIATES Powers David R. MD 110 North First Street Amite LA 70422 20 2K 1 >=18 1 2 2 30726886 90510387KIDNEY & HYPERTENSION ASSOCIATES Pratt Wendy A. FNP 110 North First Street Amite LA 70422 78 79 1 >=18 1 2 2 30726886 90510387THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mitchell Dustin 216 N. Second Street Amite LA 70422 35 65 1 none 1 2 2 30728314 90511943THE PHYSICIAN'S ALLIANCE CORP (TPAC) Neal Bruce 216 N. Second Street Amite LA 70422 35 65 1 none 1 2 2 30728314 90511943THE PHYSICIAN'S ALLIANCE CORP (TPAC) Neal Melissa 216 N. Second Street Amite LA 70422 37 74 1 none 1 2 2 30728314 90511943THE PHYSICIAN'S ALLIANCE CORP (TPAC) Payne Frederick 216 N. Second Street Amite LA 70422 35 65 1 none 1 2 2 30728314 90511943THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stewart Kim 216 N. Second Street Amite LA 70422 29 71 1 none 1 2 2 30728314 90511943HOOD MEMORIAL HOSPITAL 301 West Walnut St Amite LA 70422 79 94 1 none 1 2 2 30732938 90512371HOOD MEMORIAL HOSPITAL 301 West Walnut St. Amite LA 70422 60 86 1 none 1 2 2 30732938 90512371MAUREEN BIGGS Biggs Maureen 309 W. Walnut Suite A Amite LA 70422 78 08 1 None 1 2 1 30732938 90512568DERRIS RAY Ray Derris Wayne MD 309 Walnet St Ste D Amite LA 70422 20 08 1 None 1 2 1 30732938 90512568Tangi Eyecare Associates Thomas Charles E OD 420 N Second St Amite LA 70422 28 88 1 None 2 1 2 30731191 90511993PRECISION OPTICAL OF HAMMOND INC 420 N. Second St. Amite LA 70422 28 88 1 none 1 2 2 30731191 90511993BOND EYE CLINIC INC Bessent Richard O. MD 60007 West Way Dr Amite LA 70422 20 18 1 none 1 2 2 30702800 90519000BOND EYE CLINIC INC Bond R. Hunter OD 60007 West Way Dr Amite LA 70422 28 88 1 none 1 2 1 30702800 90519000BOND EYE CLINIC INC Nelson Scott K. MD 60007 West Way Dr Amite LA 70422 20 18 1 none 1 2 2 30702800 90519000BOND EYE CLINIC INC Noguchi Barbara A. MD 60007 West Way Dr Amite LA 70422 20 18 1 none 1 2 2 30702800 90519000BOND EYE CLINIC INC Paddock Adam OD 60007 West Way Dr Amite LA 70422 28 88 1 none 1 2 1 30702800 90519000BOND EYE CLINIC INC Pradillo Alan OD 60007 West Way Dr Amite LA 70422 28 88 1 none 1 2 1 30702800 90519000BOND EYE CLINIC INC Richardson Daphne L. OD 60007 West Way Dr Amite LA 70422 28 88 1 none 1 2 1 30702800 90519000BOND EYE CLINIC INC Wroten Christopher W. OD 60007 West Way Dr Amite LA 70422 28 88 1 none 1 2 1 30702800 90519000BOND EYE CLINIC INC Wroten Sarah F. OD 60007 West Way Dr Amite LA 70422 28 88 1 none 1 2 2 30702800 90519000ORTHO & PROSTHETIC SPEC INC Relle Michael F. CPO 802 W. Oak St. Ste D Amite LA 70422 40 53 1 none 1 2 2 30726741 90519581TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Ennis Bruce 335 Austin St Bobalusa LA 70427 20 06 1 >=16 1 2 2 30789071 89861049PURNACHANDRA YERNENI Yerneni Purnachandra 1011 Avenue F Bogalusa LA 70427 20 41 1 >=18 1 2 1 30769096 89873417THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mejia Lisa P. NP 1407 Ave F Bogalusa LA 70427 78 79 1 >=18 1 2 2 30763419 89874068THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mejia Victor E 1407 Ave F Bogalusa LA 70427 20 06 1 none 1 2 2 30763419 89874068THE PHYSICIAN'S ALLIANCE CORP (TPAC) Feinberg Jill 1415 Ave F Bogalusa LA 70427 20 41 1 >=18 1 2 1 30763295 89874074JILL FEINBERG Feinberg Jill J. 1415 Avenue F Bogalusa LA 70427 20 08 1 None 1 2 2 30763295 89874074THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wall Thomas 1616 S Columbia Street Suite B Bogalusa LA 70427 35 65 1 none 1 2 2 30758955 89851065HOSSEIN TABARI Tabari Hossein K. MD 1616 S. Columbia St. Ste E Bogalusa LA 70427 20 41 1 >=18 1 2 2 30758955 89851065


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

VITAL LINK, A HOME CARE COMPANY 219 South Border Drive Bogalusa LA 70427 44 75 1 none 1 2 2 30780445 89868432THE PHYSICIAN'S ALLIANCE CORP (TPAC) Halkovic Joseph DC 225 Memphis Bogalusa LA 70427 30 35 1 none 1 2 2 30786907 89860726OPEN MRI OF WASHINGTON PARISH 2781 South Columbia Rd., Ste. B Bogalusa LA 70427 20 30 1 none 1 2 2 30739766 89848868AUDIBEL HEARING HEALTHCARE 2801 S Columbia Bogalusa LA 70427 34 64 1 none 1 2 2 30739232 89848842DAVID L. SAMUEL, M.D. Samuel David L. MD 2807 S. Columbia Bogalusa LA 70427 20 34 1 none 1 2 2 30739212 89848833REGIONAL HEALTH CARE CENTER Casama Rogelio A. MD 2807 S. Columbia Rd Bogalusa LA 70427 20 41 1 >=18 1 2 1 30739212 89848833ANOOP K. SINGH, MD LLC Singh Anoop K. MD 327 Memphis Street Bogalusa LA 70427 20 1T 1 none 1 2 1 30788103 89860375TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Carr Martha 335 Austin St Bogalusa LA 70427 20 06 1 >=16 1 2 1 30789071 89861049KIDNEY & HYPERTENSION ASSOCIATES Bean Brandon K. 335 Austin Street Bogalusa LA 70427 20 2K 1 >=18 1 2 2 30789071 89861049KIDNEY & HYPERTENSION ASSOCIATES Kapoor Mohit MD 335 Austin Street Bogalusa LA 70427 20 2K 1 >=18 1 2 2 30789071 89861049KIDNEY & HYPERTENSION ASSOCIATES Powers David R. MD 335 Austin Street Bogalusa LA 70427 20 2K 1 >=18 1 2 2 30789071 89861049KIDNEY & HYPERTENSION ASSOCIATES Pratt Wendy A. FNP 335 Austin Street Bogalusa LA 70427 78 79 1 >=18 1 2 2 30789071 89861049THE PHYSICIAN'S ALLIANCE CORP (TPAC) Galofaro Brian 400 Memphis Bogalusa LA 70427 20 08 1 none 1 2 2 30788987 89859801THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cain Elizabeth 400 Memphis Street Bogalusa LA 70427 20 08 1 none 1 2 2 30788987 89859801THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campbell Walter 400 Memphis Street East Clinic Bogalusa LA 70427 20 41 1 >=18 1 2 2 30788987 89859801THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campbell, Jr. Walter Lee 400 Memphis Street East Clinic Bogalusa LA 70427 20 2I 1 none 1 2 2 30788987 89859801CAPITOL CITY FAMILY HEALTH CENTER, INC Campbell, Jr. Walter MD 400 Memphis Street East Clinic Bogalusa LA 70427 20 41 1 >=18 1 2 1 30788987 89859801LASALLE GENERAL HOSP HBP Gallaspy John W. 400 Memphis Street West Clinic Bogalusa LA 70427 20 16 1 >=16 1 2 2 30788987 89859801THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jasani Rojina 400 Memphis Street West Clinic Bogalusa LA 70427 20 16 1 >=16 1 2 2 30788987 89859801THE PEDIATRIC CLINIC Palazzo Anthony J. MD 405 Ave F Bogalusa LA 70427 20 37 1 none 1 2 1 30778973 89870543THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lamartina John J. 420 Avenue F Bogalusa LA 70427 20 08 1 none 1 2 2 30778795 89870264THE PHYSICIAN'S ALLIANCE CORP (TPAC) 433 Plaza Bogalusa LA 70427 91 05 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lanassa James E. 433 Plaza Blvd Bogalusa LA 70427 20 41 1 >=18 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cazayoux Walter 433 Plaza St Bogalusa LA 70427 20 34 1 none 1 2 2 30778290 89868277Richard Colon-Ortiz MD Colon Richard MD 433 Plaza St Ste 2B Bogalusa LA 70427 20 06 1 >=19 2 1 1 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Roy Melissa 433 Plaza St Bogalusa LA 70427 20 37 1 <=18 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) East Mark DO 433 Plaza Stree Bogalusa LA 70427 19 41 1 >=18 1 2 2 30776511 89849062THE PHYSICIAN'S ALLIANCE CORP (TPAC) 433 Plaza Street Bogalusa LA 70427 65 22 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Agena Gary 433 Plaza Street Bogalusa LA 70427 20 16 1 >=16 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Alleyn Jaime J. 433 Plaza Street Bogalusa LA 70427 20 16 1 >=16 1 2 2 30778290 89868277DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS Alleyn James 433 Plaza Street Bogalusa LA 70427 20 16 1 >=16 1 2 1 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ananth Mamatha 433 Plaza Street Bogalusa LA 70427 20 37 1 <=18 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bedestani Ahmet 433 Plaza Street Bogalusa LA 70427 20 16 1 >=16 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bouligny Randy P. 433 Plaza Street Bogalusa LA 70427 20 18 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cain Elizabeth 433 Plaza Street Bogalusa LA 70427 20 08 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campbell Walter 433 Plaza Street East Clinic Bogalusa LA 70427 20 41 1 >=18 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campbell, Jr. Walter Lee 433 Plaza Street East Clinic Bogalusa LA 70427 20 2I 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chiota, Jr. Joseph 433 Plaza Street Bogalusa LA 70427 20 06 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Diket Albert L. 433 Plaza Street Bogalusa LA 70427 20 16 1 >=16 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Friend Richard D. 433 Plaza Street Bogalusa LA 70427 20 08 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ghafar Mohamed 433 Plaza Street Bogalusa LA 70427 20 16 1 >=16 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Helmcke Frederick R. 433 Plaza Street Bogalusa LA 70427 20 06 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hortman Richard 433 Plaza Street Bogalusa LA 70427 20 08 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hussain Hamid 433 Plaza Street Bogalusa LA 70427 20 10 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Karlin Richard M. 433 Plaza Street Suite 3a Bogalusa LA 70427 20 02 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lanata Gregory P. 433 Plaza Street Suite 1a Bogalusa LA 70427 32 48 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mejia Victor E 433 Plaza Street Bogalusa LA 70427 20 06 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Newman William P. 433 Plaza Street Bogalusa LA 70427 65 22 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pham Anthony T. 433 Plaza Street Bogalusa LA 70427 20 41 1 >=18 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ruiz-calderon Bernardo A. 433 Plaza Street Bogalusa LA 70427 65 22 1 none 1 2 2 30778290 89868277


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Shamsnia Morteza 433 Plaza Street Suite B1 Bogalusa LA 70427 20 41 1 >=18 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Simon John 433 Plaza Street Suite B1 Bogalusa LA 70427 20 1C 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Simon John 433 Plaza Street Suite B1 Bogalusa LA 70427 20 2K 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith Monica ARNP 433 Plaza Street 2nd Fl Bogalusa LA 70427 78 08 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) St Amant Marshall S. 433 Plaza Street 2nd Fl Bogalusa LA 70427 20 16 1 >=16 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stedman Charles 433 Plaza Street Bogalusa LA 70427 20 16 1 >=16 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tadikonda Sreenivasa 433 Plaza Street Bogalusa LA 70427 20 41 1 >=18 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Texada David 433 Plaza Street Bogalusa LA 70427 20 16 1 >=16 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Veillon Edward 433 Plaza Street 2nd Fl Bogalusa LA 70427 20 16 1 >=16 1 2 2 30778290 89868277LAKE AREA PHYSICIAN SVC LLC Veillon, Jr. Edward MD 433 Plaza Street 2nd Fl Bogalusa LA 70427 20 16 1 >=16 1 2 1 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Winfield Felton L. 433 Plaza Street 2nd Fl Bogalusa LA 70427 20 16 1 >=16 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Killen David 528 Avenue F Bogalusa LA 70427 30 35 1 none 1 2 2 30777497 89870613CAN INC. Nassauer Charles A. OD 601 Georgia Ave Bogalusa LA 70427 28 88 1 none 1 2 1 30786378 89855335THE PHYSICIAN'S ALLIANCE CORP (TPAC) Aita-Levy Jerussa 712 Willis Ave Suite 4 Bogalusa LA 70427 20 37 1 <=18 1 2 2 30782506 89869975THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mangat Raghubir 712 Willis Ave Bogalusa LA 70427 20 37 1 <=18 1 2 2 30782506 89869975THE PHYSICIAN'S ALLIANCE CORP (TPAC) Theriault Victor G 712 Willis Ave Bogalusa LA 70427 20 08 1 None 1 2 2 30782506 89869975THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bergsma Donald 712 Willis Ave, Ste 4 Bogalusa LA 70427 20 18 1 none 1 2 2 30782506 89869975THE PHYSICIAN'S ALLIANCE CORP (TPAC) Connolly Christine 712 Willis Ave, Ste 4 Bogalusa LA 70427 20 18 1 none 1 2 2 30782506 89869975THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gill Steve 712 Willis Ave, Ste 4 Bogalusa LA 70427 20 18 1 none 1 2 2 30782506 89869975VISION OPTIQUE INC Gill Steve OD 712 Willis Ave, Ste 4 Bogalusa LA 70427 28 88 1 none 1 2 2 30782506 89869975THE PHYSICIAN'S ALLIANCE CORP (TPAC) Beatty Kathryn 712 Willis Avenue Suite 4 Bogalusa LA 70427 20 37 1 <=18 1 2 2 30782506 89869975THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mouallem Raja K. 712 Willis Avenue Suite 4 Bogalusa LA 70427 20 37 1 <=18 1 2 2 30782506 89869975THE PHYSICIAN'S ALLIANCE CORP (TPAC) Verhulst John 433 Plaza Bogulura LA 70427 20 02 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) 433 Plaza Bogulusa LA 70427 65 22 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) 433 Plaza Bogulusa LA 70427 20 30 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Appurao Jayagopal 433 Plaza Bogulusa LA 70427 20 02 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bretey Tammy 433 Plaza Bogulusa LA 70427 78 79 1 >=18 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Carpenter Michael W. 433 Plaza Bogulusa LA 70427 20 02 1 none 1 2 2 30778290 89868277Ochsner Clinic Corkern Kelly B. 433 Plaza Bogulusa LA 70427 78 79 1 >=18 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gordon Richard 433 Plaza Bogulusa LA 70427 20 30 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Heintz Ludwig 433 Plaza Bogulusa LA 70427 20 02 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mixon Stephen ARPN 433 Plaza Bogulusa LA 70427 78 79 1 >=18 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Napier Malcolm 433 Plaza Bogulusa LA 70427 20 2K 1 none 1 2 2 30778290 89868277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tabari Hossein K 433 Plaza Bogulusa LA 70427 20 2K 1 none 1 2 2 30778290 89868277TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Aristimuno Gerardo 335 Austin St Bobalusa LA 70433 20 06 1 >=16 1 2 2 30465497 90107431THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gupta Sushma Highland Park Plaza, Ste 108 Convington LA 70433 20 03 1 none 1 2 1 30457770 90133492PARISH ANESTHESIA OF COVINGTON Cruise Grover S. CRNA 95 Judge Tanner Blvd Covingtion LA 70433 91 05 1 none 1 2 2 30409940 90082396Quest Diagnostics #9 Starbrush Circle Suite 102 Covington LA 70433 20 30 1 none 1 1 2 30462804 90121366Ochsner Clinic Adolph Vincent R. 1000 Ochsner Blvd. Covington LA 70433 20 02 1 none 1 2 1 30450282 90137968Ochsner Clinic Andry, Jr. Malcom E. 1000 Ochsner Blvd. Covington LA 70433 20 10 1 none 1 2 2 30450282 90137968Ochsner Clinic Anthony Michelle 1000 Ochsner Blvd. Covington LA 70433 79 79 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Babycos Christopher R. 1000 Ochsner Blvd. Covington LA 70433 20 24 1 none 1 2 2 30450282 90137968Ochsner Clinic Baham Julie M. 1000 Ochsner Blvd. Covington LA 70433 20 37 1 <=18 1 2 1 30450282 90137968Ochsner Clinic Barfield William T. 1000 Ochsner Blvd. Covington LA 70433 20 41 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Benning Gurpal S. 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Blessey Peter B. 1000 Ochsner Blvd. Covington LA 70433 20 20 1 none 1 2 2 30450282 90137968Ochsner Clinic Blonde Lawrence 1000 Ochsner Blvd. Covington LA 70433 20 2E 1 none 1 2 2 30450282 90137968Ochsner Clinic Bossenmeyer David 1000 Ochsner Blvd. Covington LA 70433 78 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Bradford Roger M. 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Broussard David M. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Butz Monica 1000 Ochsner Blvd. Covington LA 70433 78 79 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Chava Pavon 1000 Ochsner Blvd. Covington LA 70433 19 2E 1 none 1 2 2 30450282 90137968Ochsner Clinic Cloud Spring Neill PT 1000 Ochsner Blvd. Covington LA 70433 20 37 1 <=18 1 2 2 30450282 90137968Ochsner Clinic Dasgupta Anjali 1000 Ochsner Blvd. Covington LA 70433 20 41 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Devraj Timothy 1000 Ochsner Blvd. Covington LA 70433 20 20 1 none 1 2 2 30450282 90137968Ochsner Clinic DiCorte Charles J. 1000 Ochsner Blvd. Covington LA 70433 20 33 1 none 1 2 2 30450282 90137968Ochsner Clinic Dupre Jennifer 1000 Ochsner Blvd. Covington LA 70433 34 64 1 none 1 2 2 30450282 90137968Ochsner Clinic Eckholdt Gregory J. 1000 Ochsner Blvd. Covington LA 70433 20 33 1 none 1 2 1 30450282 90137968Ochsner Clinic Fitzpatrick James B. 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Foreman Mary 1000 Ochsner Blvd. Covington LA 70433 34 64 1 none 1 2 2 30450282 90137968Ochsner Clinic Franklin Thom A. 1000 Ochsner Blvd. Covington LA 70433 20 41 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Grembowicz Meridith PT 1000 Ochsner Blvd. Covington LA 70433 20 37 1 <=18 1 2 2 30450282 90137968Ochsner Clinic Guarisco Steven A. 1000 Ochsner Blvd. Covington LA 70433 20 10 1 none 1 2 2 30450282 90137968Ochsner Clinic Guidry Patricia B. 1000 Ochsner Blvd. Covington LA 70433 20 41 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Hajjar Joseph D. 1000 Ochsner Blvd. Covington LA 70433 20 30 1 none 1 2 2 30450282 90137968Ochsner Clinic Hake Sue A. PT 1000 Ochsner Blvd. Covington LA 70433 32 48 1 none 1 2 2 30450282 90137968Ochsner Clinic Hamner John Blair 1000 Ochsner Blvd. Covington LA 70433 20 02 1 none 1 2 2 30450282 90137968Ochsner Clinic Harrison Nathan J. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Hassett Cathryn C. 1000 Ochsner Blvd. Covington LA 70433 20 03 1 none 1 2 2 30450282 90137968Ochsner Clinic Isa George F. 1000 Ochsner Blvd. Covington LA 70433 20 06 1 none 1 2 2 30450282 90137968Ochsner Clinic LaMartiniere Randy J. 1000 Ochsner Blvd. Covington LA 70433 20 41 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Linson J. David 1000 Ochsner Blvd. Covington LA 70433 28 88 1 none 1 2 2 30450282 90137968Ochsner Clinic Lowder, Jr. Carl E. 1000 Ochsner Blvd. Covington LA 70433 20 14 1 none 1 2 2 30450282 90137968Ochsner Clinic Marek, Jr. Richard G. 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Martin, Jr. E. Edward 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Mokry Daniel P. 1000 Ochsner Blvd. Covington LA 70433 20 16 1 >=16 1 2 1 30450282 90137968Ochsner Clinic Morin Daniel P. 1000 Ochsner Blvd. Covington LA 70433 20 06 1 none 1 2 2 30450282 90137968Ochsner Clinic Nieto Sandra S. PT 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Omoro Sophia A. 1000 Ochsner Blvd. Covington LA 70433 20 04 1 none 1 2 2 30450282 90137968Ochsner Clinic Orejarena Leonardo A. 1000 Ochsner Blvd. Covington LA 70433 20 06 1 none 1 2 2 30450282 90137968Ochsner Clinic Palo Matti W. 1000 Ochsner Blvd. Covington LA 70433 20 20 1 none 1 2 2 30450282 90137968Ochsner Clinic Patel Smita S. 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Plaisance Kevin C. 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 1 30450282 90137968Ochsner Clinic Prabaharan Velummylum 1000 Ochsner Blvd. Covington LA 70433 20 41 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Randrup Eduardo R. 1000 Ochsner Blvd. Covington LA 70433 20 34 1 none 1 2 2 30450282 90137968Ochsner Clinic Rathe Marie T. 1000 Ochsner Blvd. Covington LA 70433 78 79 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Reiser-Parmenter Jeryl L. 1000 Ochsner Blvd. Covington LA 70433 19 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Riddell Timothy L. 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Rowan Darren M. 1000 Ochsner Blvd. Covington LA 70433 20 02 1 none 1 2 2 30450282 90137968Ochsner Clinic Rutter Cheryl 1000 Ochsner Blvd. Covington LA 70433 78 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Smith Sumathi S. 1000 Ochsner Blvd. Covington LA 70433 20 2H 1 none 1 2 2 30450282 90137968Ochsner Clinic Valliant Kristin F. 1000 Ochsner Blvd. Covington LA 70433 20 41 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Weed William C. 1000 Ochsner Blvd. Covington LA 70433 20 34 1 none 1 2 2 30450282 90137968Ochsner Clinic Bizette Greg A. 1000 Ochsner Blvd. Covington LA 70433 20 2H 1 none 1 2 2 30450282 90137968Ochsner Clinic Bowie R. Earl 1000 Ochsner Blvd. Covington LA 70433 20 04 1 none 1 2 2 30450282 90137968Ochsner Clinic Busch Eric H. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Cederbom Gunnar 1000 Ochsner Blvd. Covington LA 70433 20 30 1 none 1 2 2 30450282 90137968Ochsner Clinic Colegrove Jeffery A. 1000 Ochsner Blvd. Covington LA 70433 28 88 1 none 1 2 2 30450282 90137968Ochsner Clinic Cousins James R. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Dalovisio Joseph R. 1000 Ochsner Blvd. Covington LA 70433 20 2I 1 none 1 2 2 30450282 90137968


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Daly, Jr. William J. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Doneyhue Wendy J. 1000 Ochsner Blvd. Covington LA 70433 20 18 1 none 1 2 2 30450282 90137968Ochsner Clinic Dowling Adam M. 1000 Ochsner Blvd. Covington LA 70433 20 30 1 none 1 2 2 30450282 90137968Ochsner Clinic Evans Bryan M. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Ganier, Jr. Donald R. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Garcia-Diaz Julia B. 1000 Ochsner Blvd. Covington LA 70433 20 2I 1 none 1 2 2 30450282 90137968Ochsner Clinic Gutkin Alexander I. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Hake Daniel H. 1000 Ochsner Blvd. Covington LA 70433 32 48 1 none 1 2 2 30450282 90137968Ochsner Clinic Harmon Donald E. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Hart Stuart R. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Jens Daniel K. 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Jolliff Natalia M. 1000 Ochsner Blvd. Covington LA 70433 35 65 1 none 1 2 2 30450282 90137968Ochsner Clinic Joshi Shobha N. 1000 Ochsner Blvd. Covington LA 70433 20 10 1 none 1 2 2 30450282 90137968Ochsner Clinic Karnik Vilasini S. PT 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Keller Gerald C. PT 1000 Ochsner Blvd. Covington LA 70433 20 08 1 None 1 2 2 30450282 90137968Ochsner Clinic Kemmerly Sandra A. 1000 Ochsner Blvd. Covington LA 70433 20 2I 1 none 1 2 2 30450282 90137968Ochsner Clinic Khan Muhammad Ali 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Layman Todd E. 1000 Ochsner Blvd. Covington LA 70433 20 30 1 none 1 2 1 30450282 90137968Ochsner Clinic Lecce Michael D. 1000 Ochsner Blvd. Covington LA 70433 20 06 1 none 1 2 2 30450282 90137968Ochsner Clinic Marino Robert J. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Mayeaux Carl A. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Mazzulla Anthony D. 1000 Ochsner Blvd. Covington LA 70433 20 18 1 none 1 2 2 30450282 90137968Ochsner Clinic McBurney Donald B. 1000 Ochsner Blvd. Covington LA 70433 20 30 1 none 1 2 2 30450282 90137968Ochsner Clinic Mena Jose 1000 Ochsner Blvd. Covington LA 70433 20 33 1 none 1 2 2 30450282 90137968Ochsner Clinic Mendoza Douglas K. 1000 Ochsner Blvd. Covington LA 70433 20 06 1 none 1 2 1 30450282 90137968Ochsner Clinic Mikdadi Ghiath M. 1000 Ochsner Blvd. Covington LA 70433 20 06 1 none 1 2 1 30450282 90137968Ochsner Clinic Nachar Oussama 1000 Ochsner Blvd. Covington LA 70433 20 30 1 none 1 2 2 30450282 90137968Ochsner Clinic Nossaman Bobby D. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Pankey George A. PT 1000 Ochsner Blvd. Covington LA 70433 20 2I 1 >=18 1 2 2 30450282 90137968Ochsner Clinic Phillips, Jr. Austin G. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Restrepo Robert 1000 Ochsner Blvd. Covington LA 70433 20 30 1 none 1 2 2 30450282 90137968Ochsner Clinic Ritter Melody J. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Royster Eric I. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Smilari Thom F. 1000 Ochsner Blvd. Covington LA 70433 20 22 1 none 1 2 2 30450282 90137968Ochsner Clinic Stedman Peter M. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Stedman Robin B. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Sumrall W. David 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Taylor Connie E. 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Thomas Leslie C. PT 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Thomas Mack A. PT 1000 Ochsner Blvd. Covington LA 70433 20 05 1 none 1 2 2 30450282 90137968Ochsner Clinic Togami Joanna 1000 Ochsner Blvd. Covington LA 70433 20 34 1 none 1 2 2 30450282 90137968Ochsner Clinic Uwaifo Omotola O. 1000 Ochsner Blvd. Covington LA 70433 20 1C 1 none 1 2 2 30450282 90137968Ochsner Clinic Wiedemann, Jr. Alfred G. 1000 Ochsner Blvd. Covington LA 70433 20 16 1 >=16 1 2 2 30450282 90137968Ochsner Clinic Wolf Gary J. 1000 Ochsner Blvd. Covington LA 70433 20 02 1 none 1 2 2 30450282 90137968Ochsner Clinic Young Thomas W. 1000 Ochsner Blvd. Covington LA 70433 20 1D 1 none 1 2 1 30450282 90137968THE PHYSICIAN'S ALLIANCE CORP (TPAC) Drude, Jr Richard 101 E Fairway Drive Suite 206b Covington LA 70433 20 10 1 none 1 2 2 30409896 90082030Ochsner Clinic Mokry Daniel P. 101 East Fairway Dr. Suite 301 Covington LA 70433 20 16 1 >=16 1 2 1 30409896 90082030Ochsner Clinic Cunningham Robert J. 101 East Fairway Dr. Covington LA 70433 20 2K 1 none 1 2 2 30409896 90082030Ochsner Clinic Urrego Fernando A. 101 East Fairway Dr. Covington LA 70433 20 29 1 none 1 2 1 30409896 90082030ORTHO & PROSTHETIC SPEC INC Relle Michael F. CPO 101 Highland Park Plaza Covington LA 70433 40 53 1 none 1 2 2 30457728 90133810


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

LA Heart Center Arena Frank J MD 101 Judge Tanner Blvd Ste 106 Covington LA 70433 20 06 1 >=18 2 1 2 30409896 90082030TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Aristimuno Gerardo 101 Judge Tanner Blvd Ste 504 Covington LA 70433 20 06 1 >=16 1 2 2 30409896 90082030TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Carr Martha 101 Judge Tanner Blvd Ste 504 Covington LA 70433 20 06 1 >=16 1 2 1 30409896 90082030TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Ennis Bruce 101 Judge Tanner Blvd Ste 504 Covington LA 70433 20 06 1 >=16 1 2 2 30409896 90082030TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Hardwich, III James O. 101 Judge Tanner Blvd Ste 504 Covington LA 70433 20 06 1 >=16 1 2 2 30409896 90082030LA Heart Center Hickey Keith G MD 101 Judge Tanner Blvd Ste 106 Covington LA 70433 20 06 1 >=18 2 1 2 30409896 90082030TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Kanagala Ravi 101 Judge Tanner Blvd Ste 504 Covington LA 70433 20 06 1 >=16 1 2 2 30409896 90082030TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Lasala Gabriel 101 Judge Tanner Blvd Ste 504 Covington LA 70433 20 06 1 >=16 1 2 1 30409896 90082030TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Silva Jose 101 Judge Tanner Blvd Ste 504 Covington LA 70433 20 06 1 >=16 1 2 1 30409896 90082030LA Heart Center Stein Jeffrey J NP 101 Judge Tanner Blvd Ste 106 Covington LA 70433 78 87 1 >=18 2 1 2 30409896 90082030TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Voelker, III Frank 101 Judge Tanner Blvd Ste 504 Covington LA 70433 20 06 1 >=16 1 2 2 30409896 90082030LA HEART CENTER Arena Frank MD 101 Judge Tanner Blvd. Suite 106 Covington LA 70433 20 06 1 none 1 2 2 30409896 90082030Ochsner Clinic Baham Julie M. 101 Judge Tanner Blvd. Suite 302 Covington LA 70433 20 37 1 <=18 1 2 1 30409896 90082030LA HEART CENTER Bernstein Marc MD 101 Judge Tanner Blvd. Suite 106 Covington LA 70433 20 06 1 none 1 2 2 30409896 90082030LAKEVIEW MULTISPECIALTY GROUP, LLC CHRISTOPHER James MD 101 Judge Tanner Blvd. Suite 402 Covington LA 70433 20 02 1 none 1 1 2 30409896 90082030Ochsner Clinic Cloud Spring Neill PT 101 Judge Tanner Blvd. Suite 302 Covington LA 70433 20 37 1 <=18 1 2 2 30409896 90082030Ochsner Clinic Fitzpatrick Jill A. 101 Judge Tanner Blvd. Suite 302 Covington LA 70433 20 37 1 <=18 1 2 2 30409896 90082030Ochsner Clinic Grembowicz Meridith PT 101 Judge Tanner Blvd. Suite 302 Covington LA 70433 20 37 1 <=18 1 2 2 30409896 90082030LAKEVIEW MULTISPECIALTY GROUP, LLC HARKNESS Stephen MD 101 Judge Tanner Blvd. Suite 402 Covington LA 70433 20 02 1 none 1 1 2 30409896 90082030LA HEART CENTER Hickey Keith MD 101 Judge Tanner Blvd. Suite 106 Covington LA 70433 20 06 1 none 1 2 2 30409896 90082030LA HEART CENTER Iteld Bruce MD 101 Judge Tanner Blvd. Suite 106 Covington LA 70433 20 06 1 none 1 2 1 30409896 90082030Ochsner Clinic Joseph, Jr. Gerald F. 101 Judge Tanner Blvd. Suite 301 Covington LA 70433 20 16 1 >=16 1 2 2 30409896 90082030Ochsner Clinic Newman Chevies W. 101 Judge Tanner Blvd. Suite 301 Covington LA 70433 20 16 1 >=16 1 2 1 30409896 90082030LAKEVIEW MULTISPECIALTY GROUP, LLC O'CONNELL Ruary MD 101 Judge Tanner Blvd. Suite 402 Covington LA 70433 20 02 1 none 1 1 2 30409896 90082030LAKEVIEW MULTISPECIALTY GROUP, LLC PELIAS Marilyn MD 101 Judge Tanner Blvd. Suite 402 Covington LA 70433 20 02 1 none 1 1 2 30409896 90082030Ochsner Clinic Richard Pamela E. 101 Judge Tanner Blvd. Suite 302 Covington LA 70433 20 37 1 <=18 1 2 2 30409896 90082030Ochsner Clinic Seymour Mary L. 101 Judge Tanner Blvd. Suite 302 Covington LA 70433 20 37 1 <=18 1 2 2 30409896 90082030LA HEART CENTER Sharma Sushant MD 101 Judge Tanner Blvd. Suite 106 Covington LA 70433 20 06 1 none 1 2 2 30409896 90082030LA HEART CENTER Silverstein Jay MD 101 Judge Tanner Blvd. Suite 106 Covington LA 70433 20 06 1 none 1 2 2 30409896 90082030LA HEART CENTER Stein Jeffrey NP 101 Judge Tanner Blvd. Suite 106 Covington LA 70433 78 79 1 >=18 1 2 2 30409896 90082030Ochsner Clinic Swiger Johnny W. 101 Judge Tanner Blvd. Suite 301 Covington LA 70433 20 16 1 >=16 1 2 1 30409896 90082030Ochsner Clinic Thomas Nancy N. 101 Judge Tanner Blvd. Suite 301 Covington LA 70433 20 16 1 >=16 1 2 1 30409896 90082030THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brown Gary R. 1011 S Tyler Street Covington LA 70433 20 07 1 none 1 2 2 30470581 90112881SONDES MEDICAL ASSOCIATES Sonders Scott MD 1016 1/2 W. 21st Ave Covington LA 70433 35 65 1 none 1 2 2 30480229 90109588THE PHYSICIAN'S ALLIANCE CORP (TPAC) Starke Ulrich 102 Highland Park Plaza Covington LA 70433 20 41 1 >=18 1 2 2 30457736 90133491NORTHLAKE MEDICAL SUPPLY INC 1028 S. Tyler Street Covington LA 70433 40 54 1 none 1 2 2 30470323 90112698GUPTA SATYARTHI MD Gupta Satyarthi MD 108 Highland Park Plaza Covington LA 70433 20 18 1 none 1 2 2 30457770 90133492DOTY PAUL M MD Doty Paul M. MD 1115 S. Tyler Street Covington LA 70433 20 20 1 none 1 2 1 30469704 90113557DATA SERVICE RADIOLOGY Hall Michael David 120 Innwood Dr Covington LA 70433 20 30 1 none 1 2 1 30460996 90118955DATA SERVICE RADIOLOGY Kite Roy Ambrose 120 Innwood Dr Covington LA 70433 20 30 1 none 1 2 1 30460996 90118955DATA SERVICE RADIOLOGY Pflug Steven Frederic 120 Innwood Dr. Covington LA 70433 20 30 1 none 1 2 1 30460996 90118955THE PHYSICIAN'S ALLIANCE CORP (TPAC) Keshelava George 1202 South Tyler Street Covington LA 70433 20 41 1 >=18 1 2 1 30468771 90113885NORTHLAKE PULMONARY ASSOCIATES INC Blanco Ricardo E. MD 1203 S. Tyler St Ste 200 Covington LA 70433 20 29 1 >=16 1 2 2 30468915 90114156NORTHLAKE PULMONARY ASSOCIATES INC Casey Richard E. MD 1203 S. Tyler St Ste 200 Covington LA 70433 20 29 1 >=16 1 2 2 30468915 90114156NORTHLAKE PULMONARY ASSOCIATES INC Cressy, Jr. David S. DO 1203 S. Tyler St Ste 200 Covington LA 70433 19 29 1 >=16 1 2 2 30468915 90114156NORTHLAKE PULMONARY ASSOCIATES INC Knower Mark T. MD 1203 S. Tyler St Ste 200 Covington LA 70433 20 29 1 >=16 1 2 2 30468915 90114156NORTHLAKE PULMONARY ASSOCIATES INC Kuebel Donald A. MD 1203 S. Tyler St Ste 200 Covington LA 70433 20 29 1 >=16 1 2 2 30468915 90114156MARY BIRD PERKINS CANCER CTR Bermudez Richard Scott 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 2 30468915 90114156MARY BIRD PERKINS CANCER CTR Boyer Cynthia I. 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 2 30468915 90114156MARY BIRD PERKINS CANCER CTR Fields Robert S. 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 2 30468915 90114156


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

MARY BIRD PERKINS CANCER CTR Henkelmann Gregory C. 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 2 30468915 90114156MARY BIRD PERKINS CANCER CTR Johnson Sheldon A. 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 1 30468915 90114156MARY BIRD PERKINS CANCER CTR King, Jr. Maurice L. 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 1 30468915 90114156MARY BIRD PERKINS CANCER CTR Levine Renee A. 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 2 30468915 90114156MARY BIRD PERKINS CANCER CTR Lo Kenneth K. 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 2 30468915 90114156MARY BIRD PERKINS CANCER CTR Long Jeffrey P. 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 2 30468915 90114156MARY BIRD PERKINS CANCER CTR Sanders Mary Ella 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 2 30468915 90114156MARY BIRD PERKINS CANCER CTR Wood Charles G. 1203 S. Tyler St., Ste. 100 Covington LA 70433 20 2J 1 >=18 1 2 2 30468915 90114156LAKEVIEW MULTISPECIALTY GROUP, LLC DAVIS Troy MD 130 Lakeview Circle Covington LA 70433 20 41 1 none 1 1 2 30410000 90080800LAKEVIEW MULTISPECIALTY GROUP, LLC GUILLOT Jacques MD 130 Lakeview Circle Covington LA 70433 20 41 1 none 1 1 2 30410000 90080800LAKEVIEW MULTISPECIALTY GROUP, LLC JEANSONNE Richard MD 130 Lakeview Circle Covington LA 70433 20 08 1 none 1 1 2 30410000 90080800LAKEVIEW MULTISPECIALTY GROUP, LLC OVELLA Susan MD 130 Lakeview Circle Covington LA 70433 20 41 1 none 1 1 2 30410000 90080800LAKEVIEW MULTISPECIALTY GROUP, LLC SIMON-DAVIS Brandee Deanne MD 130 Lakeview Circle Covington LA 70433 20 41 1 none 1 1 2 30410000 90080800THE PHYSICIAN'S ALLIANCE CORP (TPAC) Aduli Farhad 1323 S Tyler Dr Suite 109 Covington LA 70433 20 06 1 none 1 2 2 30467918 90114923THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mace James 1323 S Tyler Dr Ste 109 Covington LA 70433 20 06 1 none 1 2 2 30467918 90114923THE PHYSICIAN'S ALLIANCE CORP (TPAC) Malik Naveed 1323 S Tyler Dr Suite 109 Covington LA 70433 20 06 1 none 1 2 1 30467918 90114923THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nagy Adriana 1323 S Tyler Dr Suite 109 Covington LA 70433 20 06 1 none 1 2 2 30467918 90114923THE PHYSICIAN'S ALLIANCE CORP (TPAC) Salam Hamid 1323 S Tyler Dr Suite 109 Covington LA 70433 20 06 1 none 1 2 2 30467918 90114923THE PHYSICIAN'S ALLIANCE CORP (TPAC) Oubre John 1323 S Tyler St Suite 102 Covington LA 70433 20 41 1 >=18 1 2 2 30467918 90114923THE PHYSICIAN'S ALLIANCE CORP (TPAC) Parker Janine 1323 S Tyler St Ste 102 Covington LA 70433 20 29 1 none 1 2 2 30467918 90114923THE PHYSICIAN'S ALLIANCE CORP (TPAC) Amkieh Ali 141 Lakeview Circle Covington LA 70433 20 06 1 none 1 2 2 30410000 90080800THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kusnick Barry 141 Lakeview Circle Covington LA 70433 20 06 1 none 1 2 2 30410000 90080800THE PHYSICIAN'S ALLIANCE CORP (TPAC) Menon Pramod 141 Lakeview Circle Covington LA 70433 20 06 1 none 1 2 1 30410000 90080800THE PHYSICIAN'S ALLIANCE CORP (TPAC) Presser, III Dale 141 Lakeview Circle Covington LA 70433 20 06 1 none 1 2 2 30410000 90080800KIDNEY & HYPERTENSION ASSOCIATES Bean Brandon K. 170 Greenbriar Blvd Suite B Covington LA 70433 20 2K 1 >=18 1 2 2 30456950 90137698KIDNEY & HYPERTENSION ASSOCIATES Kapoor Mohit MD 170 Greenbriar Blvd Suite B Covington LA 70433 20 2K 1 >=18 1 2 2 30456950 90137698KIDNEY & HYPERTENSION ASSOCIATES Powers David R. MD 170 Greenbriar Blvd Suite B Covington LA 70433 20 2K 1 >=18 1 2 2 30456950 90137698KIDNEY & HYPERTENSION ASSOCIATES Pratt Wendy A. FNP 170 Greenbriar Blvd Suite B Covington LA 70433 78 79 1 >=18 1 2 2 30456950 90137698THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barnes George 180 Greenbriar Blvd Covington LA 70433 20 33 1 none 1 2 2 30456950 90137670THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gardner Philip 180 Greenbriar Blvd Covington LA 70433 20 2P 1 none 1 2 2 30456950 90137670THE PHYSICIAN'S ALLIANCE CORP (TPAC) Robinson James 180 Greenbriar Blvd Covington LA 70433 20 41 1 >=18 1 2 2 30456950 90137670SHEEN ALAN E MD Sheen Alan E. MD 185 Greenbrier Blvd Ste B Covington LA 70433 20 03 1 none 1 2 1 30456675 90137663LOUISIANA FAMILY EYECARE LLC Anastasio Jeff 190 Greenbriar Blvd. Ste 105 Covington LA 70433 28 88 1 none 1 2 2 30456949 90137642LOUISIANA FAMILY EYECARE LLC Anastasio Shelly 190 Greenbriar Blvd. Ste 105 Covington LA 70433 28 88 1 none 1 2 2 30456949 90137642THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allbritton Beth 19105 Sandy Lane Covington LA 70433 35 65 1 none 1 2 2 30405042 90083303THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bartholomew James 19105 Sandy Lane Covington LA 70433 35 65 1 none 1 2 2 30405042 90083303THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boucher Ann 19105 Sandy Lane Covington LA 70433 37 74 1 none 1 2 2 30405042 90083303AUDIBEL HEARING HEALTHCARE 19317 N 10th St. Covington LA 70433 34 64 1 none 1 2 2 30464695 90083457SYNERGY HOME CARE-NORTHSHORE REGION 19405 Helenburg Ste 104 Covington LA 70433 44 75 1 none 1 2 2 30431738 90080456THE PHYSICIAN'S ALLIANCE CORP (TPAC) Napier Malcolm 1970 Hwy 190 Covington LA 70433 20 2K 1 none 1 2 2 30459947 90082149THE PHYSICIAN'S ALLIANCE CORP (TPAC) Simon John 1970 N Hwy 190 Covington LA 70433 20 1C 1 none 1 2 2 30459947 90082149NORTHLAKE MEDICINE AND WELLNES Levi Tonya 1980 N. Hwy 190 Covington LA 70433 20 41 1 >=18 1 2 2 30460029 90082165ELIZABETH WHITE 205 Highland Park Plaza Covington LA 70433 20 41 1 none 1 2 2 30458320 90133815ELIZABETH WHITE Brown Gretchen NP 205 Highland Park Plaza Covington LA 70433 78 79 1 >=18 1 2 2 30458320 90133815Elizabeth White MD White Elizabeth B MD 205 Highland Park Plaza Covington LA 70433 20 41 1 >9mo 2 1 2 30458320 90133815THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hedgpeth Glenn D. 207 Highland Park Plaza Covington LA 70433 20 10 1 none 1 2 1 30458332 90133815THE PHYSICIAN'S ALLIANCE CORP (TPAC) Samuels Bruce S. 207 Highland Park Plaza Covington LA 70433 20 41 1 >=18 1 2 1 30458332 90133815THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ganji Srinivas S. 209 Highland Park Plaza Covington LA 70433 20 13 1 none 1 2 2 30458343 90133815KIDNEY & HYPERTENSION ASSOCIATES Bean Brandon K. 217 Cherokee Rose Lane Covington LA 70433 20 2K 1 >=18 1 2 2 30461656 90124910KIDNEY & HYPERTENSION ASSOCIATES Kapoor Mohit MD 217 Cherokee Rose Lane Covington LA 70433 20 2K 1 >=18 1 2 2 30461656 90124910


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

KIDNEY & HYPERTENSION ASSOCIATES Powers David R. MD 217 Cherokee Rose Lane Covington LA 70433 20 2K 1 >=18 1 2 2 30461656 90124910KIDNEY & HYPERTENSION ASSOCIATES Pratt Wendy A. FNP 217 Cherokee Rose Lane Covington LA 70433 78 79 1 >=18 1 2 2 30461656 90124910JOSEPH V. SICA, O.D. Sica Joseph V. 312 S. Jefferson Avenue Covington LA 70433 28 88 1 none 1 2 2 30473337 90102196THE PHYSICIAN'S ALLIANCE CORP (TPAC) Carinder James E. 39 Starbush Cir Covington LA 70433 19 2H 1 none 1 2 2 30463747 90120344THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson, Jr. Joe E. 5001 Hwy 190 Ste A3 Covington LA 70433 20 41 1 >=18 1 2 2 30492089 90141593THE PHYSICIAN'S ALLIANCE CORP (TPAC) Depaula John M. 56 Starbush Circle Covington LA 70433 20 2I 1 none 1 2 2 30464267 90119656THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hill Michael 56 Starbush Circle Covington LA 70433 20 2I 1 none 1 2 2 30464267 90119656THE PHYSICIAN'S ALLIANCE CORP (TPAC) Laurent Merrill J. 56 Starbush Circle Covington LA 70433 20 41 1 >=18 1 2 2 30464267 90119656DIMITRI DERMATOLOGY Birkhoff Janice ANP 600 N. Hwy 190 Ste 201 Covington LA 70433 78 79 1 >=18 1 2 2 30438687 90082905DIMITRI DERMATOLOGY DiMarco Marilyn ANP 600 N. Hwy 190 Ste 201 Covington LA 70433 78 79 1 none 1 2 2 30438687 90082905DIMITRI DERMATOLOGY Dimitri Elizabeth DO 600 N. Hwy 190 Ste 201 Covington LA 70433 19 07 1 none 1 2 1 30438687 90082905DIMITRI DERMATOLOGY Janeski Belinda 600 N. Hwy 190 Ste 201 Covington LA 70433 78 79 1 none 1 2 2 30438687 90082905DIMITRI DERMATOLOGY McDonald Kate MD 600 N. Hwy 190 Ste 201 Covington LA 70433 20 07 1 none 1 2 1 30438687 90082905DIMITRI DERMATOLOGY Mosadegh Mehdi MD 600 N. Hwy 190 Ste 201 Covington LA 70433 20 07 1 none 1 2 1 30438687 90082905HANGER PROSTHETICS AND ORTHOTICS 600 North Highway 190 Ste 2 Covington LA 70433 40 53 1 none 1 2 1 30438687 90082905HANGER PROSTHETICS AND ORTHOTICS 600 North Highway 190, Suite 2 Covington LA 70433 40 53 1 none 1 2 1 30438687 90082905THE PHYSICIAN'S ALLIANCE CORP (TPAC) Buonagura Angela 606 W 11th Covington LA 70433 20 02 1 none 1 2 2 30469536 90112408THE PHYSICIAN'S ALLIANCE CORP (TPAC) Heintz Ludwig 606 W 11th Covington LA 70433 20 02 1 none 1 2 2 30469536 90112408THE PHYSICIAN'S ALLIANCE CORP (TPAC) Carpenter Michael 606 W 11th Ave Covington LA 70433 20 02 1 none 1 2 2 30469536 90112408THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dominguez Mark 606 W 11th Ave Covington LA 70433 20 02 1 none 1 2 2 30469536 90112408THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ordoyne William 606 W 11th Ave Covington LA 70433 20 02 1 none 1 2 2 30469536 90112408THE PHYSICIAN'S ALLIANCE CORP (TPAC) Verhulst John 606 W 11th Ave Covington LA 70433 20 02 1 none 1 2 2 30469536 90112408THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ashton Lisa 606 W 12th Ave Covington LA 70433 78 16 1 >=16 1 2 2 30470377 90111735THE PHYSICIAN'S ALLIANCE CORP (TPAC) Braly Patricia 606 W 12th Ave Covington LA 70433 20 16 1 >=16 1 2 2 30470377 90111735Women's Cancer Care Ashton Lisa O FNP 606 W 12th St Covington LA 70433 78 08 1 >=18 2 1 2 30470377 90111735WOMENS CANCER CARE Braly Patricia S. MD, APMC 606 W. 12th Street Covington LA 70433 20 16 1 >=16 1 2 2 30470377 90111735VITREO RETINAL EYE CENTER Gremillion Avit MD 67186 Industry Lane Ste A Covington LA 70433 20 18 1 none 1 2 2 30406733 90083132SOUTHERN PATHOLOGY APMC Bartholomew Pamela MD 67241 Industry Lane Covington LA 70433 20 22 1 none 1 2 2 30407856 90083262SOUTHERN PATHOLOGY APMC Henderson Jeremy MD 67241 Industry Lane Covington LA 70433 20 22 1 none 1 2 2 30407856 90083262SOUTHERN PATHOLOGY APMC Kaye Kim S. MD 67241 Industry Lane Covington LA 70433 20 22 1 none 1 2 2 30407856 90083262SOUTHERN PATHOLOGY APMC Martin, III Edward MD 67241 Industry Lane Covington LA 70433 20 22 1 none 1 2 2 30407856 90083262MEDICAL CENTER DIAGNOSTICS Dietz, IV Thompson MD 67250 Industry Lane Covington LA 70433 20 30 1 none 1 2 2 30407943 90082922MEDICAL CENTER DIAGNOSTICS Haley Timothy MD 67250 Industry Lane Covington LA 70433 20 30 1 none 1 2 2 30407943 90082922MEDICAL CENTER DIAGNOSTICS Tuazon Jaime S. MD 67250 Industry Lane Covington LA 70433 20 30 1 none 1 2 2 30407943 90082922SOUTHERN PATHOLOGY APMC Bartholomew Pamela MD 67252 Industry Lane Covington LA 70433 20 22 1 none 1 2 2 30407973 90082917THE PHYSICIAN'S ALLIANCE CORP (TPAC) Francis Michael 67252 Industry Lane Covington LA 70433 20 05 1 none 1 2 2 30407973 90082917SOUTHERN PATHOLOGY APMC Henderson Jeremy MD 67252 Industry Lane Covington LA 70433 20 22 1 none 1 2 2 30407973 90082917SOUTHERN PATHOLOGY APMC Kaye Kim S. MD 67252 Industry Lane Covington LA 70433 20 22 1 none 1 2 2 30407973 90082917SOUTHERN PATHOLOGY APMC Martin, III Edward MD 67252 Industry Lane Covington LA 70433 20 22 1 none 1 2 2 30407973 90082917THE PHYSICIAN'S ALLIANCE CORP (TPAC) Warden Clark F. 7015 Hwy 190 E Service Rd Ste 200 Covington LA 70433 20 02 1 none 1 2 2 30418200 90083700Tiger Vision, LLC Turia M. Theresa MD 706 W 15th Ave Covington LA 70433 20 18 1 none 1 2 2 30473610 90110575Tiger Vision, LLC Haley Henry MD 706 W. 15 Ave Covington LA 70433 20 18 1 none 1 2 2 30473610 90110575Tiger Vision, LLC Hendricks Sean MD 706 W. 15 Ave Covington LA 70433 20 18 1 none 1 2 2 30473610 90110575Tiger Vision, LLC Silbernagel Jeffrey OD 706 W. 15th Ave Covington LA 70433 19 05 1 none 1 2 1 30473610 90110575CHILDRENS MEDICAL CENTER Casey Sherri B. MD 71107 Highway 21 Covington LA 70433 20 37 1 <=18 1 2 2 30460190 90121416CHILDRENS MEDICAL CENTER Kenney Kristen F. FNP 71107 Highway 21 Covington LA 70433 78 79 1 >=18 1 2 1 30460190 90121416CHILDRENS MEDICAL CENTER Terral William L. MD 71107 Highway 21 Covington LA 70433 20 37 1 <=18 1 2 2 30460190 90121416CHILDRENS MEDICAL CENTER Williams John E. MD 71107 Highway 21 Covington LA 70433 20 37 1 <=18 1 2 1 30460190 90121416LOUISIANA HEALTHCARE ASSOCIATES 71207 Highway 21 Covington LA 70433 20 02 1 none 1 2 2 30460548 90120875THE PHYSICIAN'S ALLIANCE CORP (TPAC) Purohit Sunil 71207 Hwy 21 Covington LA 70433 20 34 1 none 1 2 2 30460548 90120875


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Purohit Surenda - Gp 71207 Hwy 21 Covington LA 70433 20 08 1 None 1 2 2 30460548 90120875THE PHYSICIAN'S ALLIANCE CORP (TPAC) Purohit Surendra-sur 71207 Hwy 21 Covington LA 70433 20 02 1 none 1 2 2 30460548 90120875LABCORP 71380 HIGHWAY 21 STE 102 COVINGTON LA 70433 20 30 1 none 1 1 2 30461274 90119668Scott P Striplin MD Striplin Scott P MD 77 Starbrush Circle Covington LA 70433 20 16 1 >=16 Female 2 1 1 30463262 90120160PALOPOLI JOHN J MD Palopoli John J. MD 907 S. Harrison St Covington LA 70433 35 65 1 none 1 2 2 30470963 90111185VASCULAR ACCESS CENTER OF NORTH SHORE LA McGurkin James MD 915 South Harrison St Covington LA 70433 20 30 1 >=16 1 2 2 30470910 90111228VASCULAR ACCESS CENTER OF NORTH SHORE LA Sager Matthew MD 915 South Harrison St Covington LA 70433 20 41 1 >=18 1 2 2 30470910 90111228VASCULAR ACCESS CENTER OF NORTH SHORE LA Smith Kyle DO 915 South Harrison St Covington LA 70433 19 41 1 >=16 1 2 2 30470910 90111228VASCULAR ACCESS CENTER OF NORTH SHORE LA Gardner Philip MD 915 South Harrison Street Covington LA 70433 20 02 1 >=18 1 2 2 30470910 90111228DATA SERVICE RADIOLOGY 95 E. Fairway Dr Covington LA 70433 20 30 1 none 1 2 2 30409940 90082396SOUTHERN MEDICAL DEVELOPMENT, INC 95 E. Fairway Dr Covington LA 70433 20 37 1 <=18 1 2 2 30409940 90082396DATA SERVICE RADIOLOGY Hall Michael David 95 E. Fairway Dr Covington LA 70433 20 30 1 none 1 2 1 30409940 90082396DATA SERVICE RADIOLOGY Kite Roy Ambrose 95 E. Fairway Dr Covington LA 70433 20 30 1 none 1 2 1 30409940 90082396SOUTHERN MEDICAL DEVELOPMENT, INC Suarez Alberto MD 95 E. Fairway Dr Covington LA 70433 20 37 1 <=18 1 2 1 30409940 90082396DATA SERVICE RADIOLOGY Pflug Steven Frederic 95 E. Fairway Dr. Covington LA 70433 20 30 1 none 1 2 1 30409940 90082396Ochsner Clinic Kumbala Damodar R. 95 East Fairway Dr. Covington LA 70433 20 41 1 >=18 1 2 2 30409940 90082396Ochsner Clinic Meadows Renee Y. 95 East Fairway Dr. Covington LA 70433 20 41 1 >=18 1 2 2 30409940 90082396Ochsner Clinic Nath Arup K. 95 East Fairway Dr. Covington LA 70433 19 41 1 >=18 1 2 2 30409940 90082396SOUTHERN PATHOLOGY APMC Bartholomew Pamela MD 95 Judge Tanner Blvd Covington LA 70433 20 22 1 none 1 2 2 30409940 90082396SOUTHERN PATHOLOGY APMC Henderson Jeremy MD 95 Judge Tanner Blvd Covington LA 70433 20 22 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Baldone David C. MD 95 Judge Tanner Blvd, Covington LA 70433 20 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Ball Brian C. MD 95 Judge Tanner Blvd, Covington LA 70433 20 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Daigle Bertha J. CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Fortenberry Damon S. CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Green Fred CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Hebert, III Lawrence J. CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Ingraham Tara CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Janssen Peter MD 95 Judge Tanner Blvd, Covington LA 70433 20 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Johnson Laura A. MD 95 Judge Tanner Blvd, Covington LA 70433 20 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON LaFrance Sharon B. CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Levine Kenneth M. MD 95 Judge Tanner Blvd, Covington LA 70433 20 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Lombardi Nicole A. CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Lyle Matthew CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Newman Patricia W. CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Nolan Richard S. CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Powell Michael S. CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Provensal Randy L. CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Schmidt David M. CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON Sullivan Wendy CRNA 95 Judge Tanner Blvd, Covington LA 70433 91 05 1 none 1 2 2 30409940 90082396PARISH ANESTHESIA OF COVINGTON 95 JUDGE TANNER BLVD. COVINGTON LA 70433 20 05 1 none 1 2 2 30409940 90082396LAKEVIEW REGIONAL MEDICAL CENTER (HCA) 95 Judge Tanner Blvd. Covington LA 70433 60 86 1 none 1 1 1 30409940 90082396SOUTHERN PATHOLOGY APMC Kaye Kim S. MD 95 Judge Tanner Blvd. Covington LA 70433 20 22 1 none 1 2 2 30409940 90082396SOUTHERN PATHOLOGY APMC Martin, III Edward MD 95 Judge Tanner Blvd. Covington LA 70433 20 22 1 none 1 2 2 30409940 90082396DEQUINCY MEMORIAL HOSPITAL Abraham Joseph MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Agrama Mahmoud MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Baldwin W. A. MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 1 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Chaisson Kevin MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Fagan Scott MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Ferderline Michael J. MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 1 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Gonsette Leslie MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

DEQUINCY MEMORIAL HOSPITAL Gupta Prashant MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Hoff Clarissa MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Hollen Jake MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Jewell, Sr. Baylor L. MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Joudeh Jalal MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 1 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Kemmerly Kenneth MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Kenyon Carolyn MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Krupkin Robert MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Lembo Craig MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Levet Barry MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Mobley Harry MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Odita Chukuemeka N. 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Rice Atwood MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098RICHARDSON MEDICAL CENTER Seyfarth Huey A. 17438 Hard Hat Drive Covington LA 70435 20 08 1 None 1 2 1 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Seyfarth, Jr. Huey A. MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 1 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Shaw Mark MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 1 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Shelton Harold MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL St. Cyr Mark MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Taylor Raymond MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 1 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Tomajan Samir MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Van-Sice Wade MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098DEQUINCY MEMORIAL HOSPITAL Wolfort Ryan M. MD 17438 Hard Hat Drive Covington LA 70435 20 1T 1 none 1 2 2 30513461 90115098LAKEVIEW MULTISPECIALTY GROUP, LLC KANAGALA Anita MD 73015 Highway 25 Covington LA 70435 20 08 1 none 1 1 2 30497500 90105200LAKEVIEW MULTISPECIALTY GROUP, LLC MURPHY Rachael MD 73015 Highway 25 Covington LA 70435 20 41 1 none 1 1 2 30497500 90105200LAKEVIEW MULTISPECIALTY GROUP, LLC TUSA Joseph MD 73015 Highway 25 Covington LA 70435 20 08 1 none 1 1 2 30497500 90105200KIDNEY & HYPERTENSION ASSOCIATES Bean Brandon K. 809 Boat Ramp Road Franklin LA 70438 20 2K 1 >=18 1 2 2 30834922 90153417KIDNEY & HYPERTENSION ASSOCIATES Kapoor Mohit MD 809 Boat Ramp Road Franklin LA 70438 20 2K 1 >=18 1 2 2 30834922 90153417KIDNEY & HYPERTENSION ASSOCIATES Pratt Wendy A. FNP 809 Boat Ramp Road Franklin LA 70438 78 79 1 >=18 1 2 2 30834922 90153417RIVERSIDE MEDICAL CENTER 1900 Main St Franklinton LA 70438 79 94 1 none 1 2 2 30833665 90151226RIVERSIDE MEDICAL CENTER Alvarado Luis MD 1900 Main St Franklinton LA 70438 20 41 1 >=18 1 2 2 30833665 90151226RIVERSIDE MEDICAL CENTER Berthelot Libeau MD 1900 Main St Franklinton LA 70438 20 08 1 None 1 2 2 30833665 90151226RIVERSIDE MEDICAL CENTER Brooke Lisa CRNA 1900 Main St Franklinton LA 70438 91 05 1 none 1 2 2 30833665 90151226RIVERSIDE MEDICAL CENTER Foret Christopher MD 1900 Main St Franklinton LA 70438 20 08 1 None 1 2 2 30833665 90151226RIVERSIDE MEDICAL CENTER James Mark MD 1900 Main St Franklinton LA 70438 20 08 1 None 1 2 2 30833665 90151226RIVERSIDE MEDICAL CENTER Lamb Hal CRNA 1900 Main St Franklinton LA 70438 91 05 1 none 1 2 2 30833665 90151226RIVERSIDE MEDICAL CENTER Magee Kyle MD 1900 Main St Franklinton LA 70438 20 41 1 >=18 1 2 2 30833665 90151226RIVERSIDE MEDICAL CENTER 1900 Main St. Franklinton LA 70438 79 94 1 none 1 2 1 30833665 90151226RIVERSIDE MEDICAL CENTER Magee Earl K. MD 1900 Main St. Franklinton LA 70438 20 37 1 none 1 2 2 30833665 90151226RIVERSIDE MEDICAL CENTER Silva Stephanie NP 1900 Main St. Franklinton LA 70438 78 08 1 none 1 2 2 30833665 90151226RIVERSIDE MEDICAL CENTER 1900 S. Main St Franklinton LA 70438 60 86 1 none 1 2 2 30833665 90151226FRANKLINTON RURAL HEALTH CLINIC 2004 J. Marvin Magee Dr. Franklinton LA 70438 20 08 1 None 1 2 1 30832974 90153474FRANKLINTON RURAL HEALTH CLINIC Tate, Jr. Bryan D. NP 2004 J. Marvin Magee Dr. Franklinton LA 70438 78 08 1 none 1 2 2 30832974 90153474FRANKLINTON RURAL HEALTH CLINIC Thomas Jerry Aroe MD 2004 J. Marvin Magee Dr. Franklinton LA 70438 20 08 1 none 1 2 1 30832974 90153474RIVERSIDE MEDICAL CENTER Tate, Jr. Bryan D. 2004 J. Marvin Magee Drive Franklinton LA 70438 78 08 1 >=18 1 2 2 30832974 90153474RIVERSIDE MEDICAL CENTER Thomas Jerry MD 2004 J. Marvin Magee Drive Franklinton LA 70438 20 08 1 None 1 2 1 30832974 90153474CHILDREN'S INTERNATIONAL Claycomb Stephen MD 2208 Washington Drive Franklinton LA 70438 20 37 1 <=18 1 2 1 30847158 90130017CHILDREN'S INTERNATIONAL Cohen Irwin MD 2208 Washington Drive Franklinton LA 70438 20 37 1 <=18 1 2 1 30847158 90130017CHILDREN'S INTERNATIONAL Hernandez Eduardo MD 2208 Washington Drive Franklinton LA 70438 20 29 1 none 1 2 1 30847158 90130017CHILDREN'S INTERNATIONAL Jeansonne Cornel MD 2208 Washington Drive Franklinton LA 70438 20 37 1 <=18 1 2 1 30847158 90130017CHILDREN'S INTERNATIONAL Moody Kristi NP 2208 Washington Drive Franklinton LA 70438 78 08 1 >=18 1 2 1 30847158 90130017


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

CHILDREN'S INTERNATIONAL Narumanchi Janani MD 2208 Washington Drive Franklinton LA 70438 20 37 1 <=18 1 2 1 30847158 90130017CHILDREN'S INTERNATIONAL Plauche Andrea NP 2208 Washington Drive Franklinton LA 70438 78 79 1 >=18 1 2 2 30847158 90130017CHILDREN'S INTERNATIONAL Pouw I.S. Victor MD 2208 Washington Drive Franklinton LA 70438 20 2E 1 none 1 2 1 30847158 90130017CHILDREN'S INTERNATIONAL Wilson Ella NP 2208 Washington Drive Franklinton LA 70438 78 08 1 >=18 1 2 1 30847158 90130017THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cain Elizabeth 51704 Hwy 438 Franklinton LA 70438 20 08 1 none 1 2 2 30968469 90029641FRANKLINTON RURAL HEALTH CLINIC Thomas Jerry Aroe MD 51704 Hwy 438 Franklinton LA 70438 20 08 1 none 1 2 1 30968469 90029641STEPHEN E WARREN LLC Cook Kristi W. 800 Riverside Dr Franklinton LA 70438 28 88 1 none 1 2 2 30833080 90153331STEPHEN E WARREN LLC Warren Stephen E. 800 Riverside Dr Franklinton LA 70438 28 88 1 none 1 2 1 30833080 90153331THE PHYSICIAN'S ALLIANCE CORP (TPAC) Verhulst John 807 Riverside Drive Franklinton LA 70438 20 02 1 none 1 2 2 30833376 90153300KIDNEY & HYPERTENSION ASSOCIATES Powers David R. MD 809 Boat Ramp Road Franklinton LA 70438 20 2K 1 >=18 1 2 2 30834922 90153417SOUTHEAST COMMUNITY HEALTH SYSTEM 1590 Hwy 1042 Greensburg LA 70441 72 9L 1 none 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Ballard Eileen 1590 Hwy 1042 Greensburg LA 70441 20 37 1 <=18 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Cecchini Heather 1590 Hwy 1042 Greensburg LA 70441 78 79 1 >=18 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Evans LaDonna 1590 Hwy 1042 Greensburg LA 70441 78 08 1 >=18 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Fontenot Deborah 1590 Hwy 1042 Greensburg LA 70441 20 08 1 None 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Kakazu Mario 1590 Hwy 1042 Greensburg LA 70441 20 08 1 None 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Miles Daraka 1590 Hwy 1042 Greensburg LA 70441 78 08 1 >=18 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Nanjappa Nagaraji 1590 Hwy 1042 Greensburg LA 70441 20 1T 1 none 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Smith Tammy 1590 Hwy 1042 Greensburg LA 70441 78 08 1 None 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM 1590 Hwy 37 Greensburg LA 70441 72 9L 1 none 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Ballard Eileen 1590 Hwy 37 Greensburg LA 70441 20 37 1 <=18 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Cecchini Heather 1590 Hwy 37 Greensburg LA 70441 78 79 1 >=18 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Evans LaDonna 1590 Hwy 37 Greensburg LA 70441 78 08 1 >=18 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Fontenot Deborah 1590 Hwy 37 Greensburg LA 70441 20 08 1 None 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Kakazu Mario 1590 Hwy 37 Greensburg LA 70441 20 08 1 None 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Miles Daraka 1590 Hwy 37 Greensburg LA 70441 78 08 1 >=18 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Nanjappa Nagaraji 1590 Hwy 37 Greensburg LA 70441 20 1T 1 none 1 2 2 30881100 90738800SOUTHEAST COMMUNITY HEALTH SYSTEM Smith Tammy 1590 Hwy 37 Greensburg LA 70441 78 08 1 None 1 2 2 30881100 90738800ST HELENA PARISH HOSPITAL 16874 Highway 43 North Greensburg LA 70441 60 86 1 none 1 2 2 30874524 90676453SOUTHEAST COMMUNITY HEALTH SYSTEM 490 Sitman St Greensburg LA 70441 72 9L 1 none 1 2 2 30916236 90754728SOUTHEAST COMMUNITY HEALTH SYSTEM Ballard Eileen 490 Sitman St Greensburg LA 70441 20 37 1 <=18 1 2 2 30916236 90754728SOUTHEAST COMMUNITY HEALTH SYSTEM Cecchini Heather 490 Sitman St Greensburg LA 70441 78 79 1 >=18 1 2 2 30916236 90754728SOUTHEAST COMMUNITY HEALTH SYSTEM Evans LaDonna 490 Sitman St Greensburg LA 70441 78 08 1 >=18 1 2 2 30916236 90754728SOUTHEAST COMMUNITY HEALTH SYSTEM Fontenot Deborah 490 Sitman St Greensburg LA 70441 20 08 1 None 1 2 2 30916236 90754728SOUTHEAST COMMUNITY HEALTH SYSTEM Kakazu Mario 490 Sitman St Greensburg LA 70441 20 08 1 None 1 2 2 30916236 90754728SOUTHEAST COMMUNITY HEALTH SYSTEM Miles Daraka 490 Sitman St Greensburg LA 70441 78 08 1 >=18 1 2 2 30916236 90754728SOUTHEAST COMMUNITY HEALTH SYSTEM Nanjappa Nagaraji 490 Sitman St Greensburg LA 70441 20 1T 1 none 1 2 2 30916236 90754728SOUTHEAST COMMUNITY HEALTH SYSTEM Smith Tammy 490 Sitman St Greensburg LA 70441 78 08 1 None 1 2 2 30916236 90754728OPPMAN EUGENE G OD Oppman Eugene OD 324 West 4th St Independence LA 70443 28 88 1 none 1 2 1 30634577 90505838PULMONARY CARE SPECIALISTS 387 West RR Ave Independence LA 70443 40 54 1 none 1 2 1 30611770 90508212KIDNEY & HYPERTENSION ASSOCIATES Bean Brandon K. 519 West Railroad Ave Independence LA 70443 20 2K 1 >=18 1 2 2 30633309 90500123KIDNEY & HYPERTENSION ASSOCIATES Kapoor Mohit MD 519 West Railroad Ave Independence LA 70443 20 2K 1 >=18 1 2 2 30633309 90500123KIDNEY & HYPERTENSION ASSOCIATES Powers David R. MD 519 West Railroad Ave Independence LA 70443 20 2K 1 >=18 1 2 2 30633309 90500123KIDNEY & HYPERTENSION ASSOCIATES Pratt Wendy A. FNP 519 West Railroad Ave Independence LA 70443 78 79 1 >=18 1 2 2 30633309 90500123THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bridges Charlie 52579 Hwy 51 S Independence LA 70443 20 34 1 none 1 2 2 30620001 90496451THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campbell Walter 52579 Hwy 51 S Independence LA 70443 20 41 1 >=18 1 2 2 30620001 90496451THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campbell, Jr. Walter Lee 52579 Hwy 51 S Independence LA 70443 20 2I 1 none 1 2 2 30620001 90496451CAPITOL CITY FAMILY HEALTH CENTER, INC Campbell, Jr. Walter MD 52579 Hwy 51 S Independence LA 70443 20 41 1 >=18 1 2 1 30620001 90496451THE PHYSICIAN'S ALLIANCE CORP (TPAC) Failla Paul 52579 Hwy 51 S Independence LA 70443 20 06 1 none 1 2 2 30620001 90496451THE PHYSICIAN'S ALLIANCE CORP (TPAC) Failla Paul J. 52579 Hwy 51 S Independence LA 70443 20 29 1 none 1 2 2 30620001 90496451


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Helmcke Frederick R. 52579 Hwy 51 S Independence LA 70443 20 06 1 none 1 2 2 30620001 90496451THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lamprecht Carl 52579 Hwy 51 S Independence LA 70443 20 08 1 none 1 2 2 30620001 90496451THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lanata Gregory P. 52579 Hwy 51 S Independence LA 70443 32 48 1 none 1 2 2 30620001 90496451THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mccormick Catherine 52579 Hwy 51 S Independence LA 70443 20 2J 1 none 1 2 2 30620001 90496451THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tucker Spencer 52579 Hwy 51 S Independence LA 70443 20 02 1 none 1 2 2 30620001 90496451KIDNEY & HYPERTENSION ASSOCIATES Kapoor Mohit MD 706 3RD St STE A Suite A Kentwood LA 70444 20 2K 1 >=18 1 2 2 30936618 90509073KIDNEY & HYPERTENSION ASSOCIATES Powers David R. MD 706 3RD St STE A Kentwood LA 70444 20 2K 1 >=18 1 2 2 30936618 90509073KIDNEY & HYPERTENSION ASSOCIATES Bean Brandon K. 706 3rd Street Suite A Kentwood LA 70444 20 2K 1 >=18 1 2 2 30936618 90509073KIDNEY & HYPERTENSION ASSOCIATES Pratt Wendy A. FNP 706 3rd Street Suite A Kentwood LA 70444 78 79 1 >=18 1 2 2 30936618 90509073CHILDREN'S INTERNATIONAL Claycomb Stephen MD 27350 Hwy 190 Lacombe LA 70445 20 37 1 <=18 1 2 1 30319800 89959345CHILDREN'S INTERNATIONAL Cohen Irwin MD 27350 Hwy 190 Lacombe LA 70445 20 37 1 <=18 1 2 1 30319800 89959345CHILDREN'S INTERNATIONAL Hernandez Eduardo MD 27350 Hwy 190 Lacombe LA 70445 20 29 1 none 1 2 1 30319800 89959345CHILDREN'S INTERNATIONAL Jeansonne Cornel MD 27350 Hwy 190 Lacombe LA 70445 20 37 1 <=18 1 2 1 30319800 89959345CHILDREN'S INTERNATIONAL Moody Kristi NP 27350 Hwy 190 Lacombe LA 70445 78 08 1 >=18 1 2 1 30319800 89959345CHILDREN'S INTERNATIONAL Narumanchi Janani MD 27350 Hwy 190 Lacombe LA 70445 20 37 1 <=18 1 2 1 30319800 89959345CHILDREN'S INTERNATIONAL Plauche Andrea NP 27350 Hwy 190 Lacombe LA 70445 78 79 1 >=18 1 2 2 30319800 89959345CHILDREN'S INTERNATIONAL Pouw I.S. Victor MD 27350 Hwy 190 Lacombe LA 70445 20 2E 1 none 1 2 1 30319800 89959345CHILDREN'S INTERNATIONAL Wilson Ella NP 27350 Hwy 190 Lacombe LA 70445 78 08 1 >=18 1 2 1 30319800 89959345THE PHYSICIAN'S ALLIANCE CORP (TPAC) Banks Gage 29301 N Dixie Ranch Road Lacombe LA 70445 35 65 1 none 1 2 2 30347300 89904100THE PHYSICIAN'S ALLIANCE CORP (TPAC) Banks Laura 29301 N Dixie Ranch Road Lacombe LA 70445 35 65 1 none 1 2 2 30347300 89904100THE PHYSICIAN'S ALLIANCE CORP (TPAC) Texada Richard 29301 N Dixie Ranch Road Lacombe LA 70445 20 20 1 none 1 2 2 30347300 89904100ST TAMMANY FIRE DISTRICT 3 60267 S. 8th St Lacombe LA 70445 51 59 1 none 1 2 2 30310532 89939577KIDNEY & HYPERTENSION ASSOCIATES Bean Brandon K. 64026 HWY 434 Lacombe LA 70445 20 2K 1 >=18 1 2 2 30362002 89913773KIDNEY & HYPERTENSION ASSOCIATES Kapoor Mohit MD 64026 HWY 434 Lacombe LA 70445 20 2K 1 >=18 1 2 2 30362002 89913773KIDNEY & HYPERTENSION ASSOCIATES Powers David R. MD 64026 HWY 434 Lacombe LA 70445 20 2K 1 >=18 1 2 2 30362002 89913773KIDNEY & HYPERTENSION ASSOCIATES Pratt Wendy A. FNP 64026 HWY 434 Lacombe LA 70445 78 79 1 >=18 1 2 2 30362002 89913773LOUISIANA MEDICAL CENTER & Heart Hospital 64030 Highway 434 Lacombe LA 70445 60 86 1 none 1 2 2 30362059 89913733SOUTHERN PATHOLOGY APMC 64030 Hwy 434 Lacombe LA 70445 20 22 1 none 1 2 2 30362059 89913733SOUTHERN PATHOLOGY APMC Bartholomew Pamela MD 64030 Hwy 434 Lacombe LA 70445 20 22 1 none 1 2 2 30362059 89913733THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bhushan Vikas 64030 Hwy 434 Lacombe LA 70445 20 30 1 none 1 2 2 30362059 89913733CRESCENT IMAGING LLC Blount, III James J. MD 64030 Hwy 434 Lacombe LA 70445 20 30 1 none 1 2 1 30362059 89913733SOUTHERN PATHOLOGY APMC Henderson Jeremy MD 64030 Hwy 434 Lacombe LA 70445 20 22 1 none 1 2 2 30362059 89913733THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hudkins Matthew 64030 Hwy 434 Lacombe LA 70445 20 30 1 none 1 2 2 30362059 89913733SOUTHERN PATHOLOGY APMC Kaye Kim S. MD 64030 Hwy 434 Lacombe LA 70445 20 22 1 none 1 2 2 30362059 89913733SOUTHERN PATHOLOGY APMC Martin, III Edward MD 64030 Hwy 434 Lacombe LA 70445 20 22 1 none 1 2 2 30362059 89913733THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schulze Eric 64030 Hwy 434 Lacombe LA 70445 20 30 1 none 1 2 2 30362059 89913733CRESCENT IMAGING LLC Silvestri Beata MD 64030 Hwy 434 Lacombe LA 70445 20 30 1 none 1 2 2 30362059 89913733CRESCENT IMAGING LLC Silvestri David D. MD 64030 Hwy 434 Lacombe LA 70445 20 30 1 none 1 2 2 30362059 89913733THE PHYSICIAN'S ALLIANCE CORP (TPAC) Taylor Harold 64030 Hwy 434 Lacombe LA 70445 20 30 1 none 1 2 2 30362059 89913733NORTHSHORE CARDIOVASCULAR ASSOCIATES Barrios Sergio MD 64040 Hwy 434 Lacombe LA 70445 20 06 1 none 1 2 2 30362203 89913633CARDIO THORACIC SURGERY Breaux John R. MD 64040 Hwy 434 Ste 100 Lacombe LA 70445 20 33 1 none 1 2 2 30362203 89913633CARDIO THORACIC SURGERY Hebert Louis D. MD 64040 Hwy 434 Ste 100 Lacombe LA 70445 20 33 1 none 1 2 1 30362203 89913633CARDIOLOGY INSTITUTE INC Bethala Vasanth K. MD 64040 Hwy 434, Ste. 105 Lacombe LA 70445 20 06 1 none 1 2 2 30362203 89913633CARDIOLOGY INSTITUTE INC Echenique Victor MD 64040 Hwy 434, Ste. 105 Lacombe LA 70445 20 06 1 none 1 2 2 30362203 89913633CARDIOLOGY INSTITUTE INC Long William J. MD 64040 Hwy 434, Ste. 105 Lacombe LA 70445 20 06 1 none 1 2 2 30362203 89913633CARDIOLOGY INSTITUTE INC Pernenkil Ratnakar MD 64040 Hwy 434, Ste. 105 Lacombe LA 70445 20 06 1 none 1 2 2 30362203 89913633CARDIOLOGY INSTITUTE INC Thomas Ignatius MD 64040 Hwy 434, Ste. 105 Lacombe LA 70445 20 06 1 none 1 2 2 30362203 89913633TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Kanagala Ravi 64040 LA Hwy 434 Ste 104 Lacombe LA 70445 20 06 1 >=16 1 2 2 30362203 89913633TCHEFUNCTE CARDIOVASCULAR ASSOCIATES Silva Jose 64040 LA Hwy 434 Ste 104 Lacombe LA 70445 20 06 1 >=16 1 2 1 30362203 89913633THE PHYSICIAN'S ALLIANCE CORP (TPAC) Becker Michael 64301 Hwy 434 Lacombe LA 70445 20 13 1 none 1 2 2 30366094 89911283


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cook Patricia 64301 Hwy 434 Lacombe LA 70445 20 13 1 none 1 2 2 30366094 89911283THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fischer Anastasia 64301 Hwy 434 Lacombe LA 70445 20 13 1 none 1 2 2 30366094 89911283THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fischer Michael 64301 Hwy 434 Lacombe LA 70445 20 13 1 none 1 2 2 30366094 89911283THE PHYSICIAN'S ALLIANCE CORP (TPAC) Glynn Patrick 64301 Hwy 434 Lacombe LA 70445 20 13 1 none 1 2 2 30366094 89911283THE PHYSICIAN'S ALLIANCE CORP (TPAC) Happel Michael 64301 Hwy 434 Lacombe LA 70445 20 13 1 none 1 2 2 30366094 89911283THE PHYSICIAN'S ALLIANCE CORP (TPAC) Houser James 64301 Hwy 434 Lacombe LA 70445 20 13 1 none 1 2 2 30366094 89911283THE PHYSICIAN'S ALLIANCE CORP (TPAC) Houser Rex 64301 Hwy 434 Lacombe LA 70445 20 13 1 none 1 2 2 30366094 89911283THE PHYSICIAN'S ALLIANCE CORP (TPAC) Krefft Thomas 64301 Hwy 434 Lacombe LA 70445 20 13 1 none 1 2 2 30366094 89911283Shannon B Stevens Stevens Shannon B OTR/L 56309 Currier Lane Loranger LA 70446 37 74 1 None 2 1 2 30677258 90409404THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jones Paul 389 Highway 21 403 Madisonville LA 70447 35 65 1 none 1 2 2 30440200 90145700THE PHYSICIAN'S ALLIANCE CORP (TPAC) Scarle Kristin 389 Highway 21 403 Madisonville LA 70447 35 65 1 none 1 2 2 30440200 90145700JONES PHYSICAL THERAPY Jones Paul 389 Hwy 21 Ste 403 Madisonville LA 70447 35 65 1 none 1 2 2 30440200 90145700NORTHSHORE DERMATOLOGY Tabor Eric N. MD 393 Hwy 21 Ste 550 Madisonville LA 70447 20 07 1 none 1 2 2 30440400 90145800Renal Physicians Group Angelo John MD 397 Hwy 21 Ste 601 Madisonville LA 70447 20 39 1 >=18 1 1 2 30440400 90145800Cheryl Brown MD Brown Cheryl MD 397 Hwy 21 Ste 601 Madisonville LA 70447 20 39 1 >=18 2 1 2 30440400 90145800VITAL LINK, A HOME CARE COMPANY 1770 Orleans Ave Mandeville LA 70448 44 75 1 none 1 2 2 30362879 90056875LABCORP 211 W CAUSEWAY APPROACH MANDEVILLE LA 70448 20 30 1 none 1 1 2 30372823 90092966Ochsner Clinic Marek, Jr. Richard G. 2810 East Causeway Approach Mandeville LA 70448 20 08 1 None 1 2 2 30369533 90073855Ochsner Clinic Martin, Jr. E. Edward 2810 East Causeway Approach Mandeville LA 70448 20 08 1 None 1 2 2 30369533 90073855Ochsner Clinic Nieto Sandra S. PT 2810 East Causeway Approach Mandeville LA 70448 20 08 1 None 1 2 2 30369533 90073855Ochsner Clinic Schiro Richelle E. 2810 East Causeway Approach Mandeville LA 70448 20 08 1 None 1 2 2 30369533 90073855Ochsner Clinic Emory W. Brooks 2810 East Causeway Approach Mandeville LA 70448 20 29 1 none 1 2 2 30369533 90073855Ochsner Clinic Keller Gerald C. PT 2810 East Causeway Approach Mandeville LA 70448 20 08 1 None 1 2 2 30369533 90073855Ochsner Clinic Lucas Jr. Victor W. 2810 East Causeway Approach Mandeville LA 70448 20 1D 1 none 1 2 1 30369533 90073855Ochsner Clinic Palmisano Vernon K. 2810 East Causeway Approach Mandeville LA 70448 20 08 1 None 1 2 2 30369533 90073855THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boudreaux Benjamin 4000 Lonesome Bend Suite A Mandeville LA 70448 20 24 1 none 1 2 2 30379915 90075014THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bennett Justin NP 12489 Home Port Dr Ste D Maurepas LA 70449 78 79 1 >=18 1 2 1 30248708 90770425RIVERSIDE FAMILY MEDICINE 12489 Home Port Dr. Suite D Maurepas LA 70449 79 94 1 none 1 2 2 30248708 90770425RIVERSIDE FAMILY MEDICINE Bennett Justin FNP 12489 Home Port Drive Suite D Maurepas LA 70449 78 08 1 none 1 2 1 30248708 90770425THE PHYSICIAN'S ALLIANCE CORP (TPAC) Harper Melody 18780 Hwy 22 Suite E Maurepas LA 70449 35 65 1 none 1 2 2 30258329 90768292THE PHYSICIAN'S ALLIANCE CORP (TPAC) Linxwiler Marcy 18780 Hwy 22 Suite E Maurepas LA 70449 35 65 1 none 1 2 2 30258329 90768292THE PHYSICIAN'S ALLIANCE CORP (TPAC) Butt Glenn 64629 Hwy 41 Pearl River LA 70452 20 41 1 >=18 1 2 2 30365186 89757278THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allen Gregory 105 East Oak Street Ponchatoula LA 70454 20 08 1 None 1 2 2 30437444 90440355THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gaudin Steve 105 East Oak Street Ponchatoula LA 70454 20 08 1 None 1 2 2 30437444 90440355THE PHYSICIAN'S ALLIANCE CORP (TPAC) Carter Karen L. 1120 Hwy 51 Ponchatoula LA 70454 30 35 1 none 1 2 2 30439015 90456159THE PHYSICIAN'S ALLIANCE CORP (TPAC) Benson Robert 180 N 5th Street Ponchatoula LA 70454 20 07 1 none 1 2 1 30440227 90439721KIDNEY & HYPERTENSION ASSOCIATES Bean Brandon K. 877 Brownswitch Road Dlidell LA 70458 20 2K 1 >=18 1 2 2 30310544 89745444KIDNEY & HYPERTENSION ASSOCIATES Kapoor Mohit MD 877 Brownswitch Road Dlidell LA 70458 20 2K 1 >=18 1 2 2 30310544 89745444KIDNEY & HYPERTENSION ASSOCIATES Pratt Wendy A. FNP 877 Brownswitch Road Dlidell LA 70458 78 79 1 >=18 1 2 2 30310544 89745444LGS MEDICAL SUPPLY 1040 Old Spanish Trail Slidell LA 70458 40 54 1 none 1 2 2 30258869 89774844Gulf Coast Rheumatology Associates 1051 Gause Blvd Ste 440 Slidell LA 70458 20 2M 1 none 1 2 2 30284510 89769761David F Slagle II MD Artigue Gary M OD 1051 Gause Blvd Ste 480 Slidell LA 70458 28 88 1 >=6 2 1 2 30284510 89769761THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bronaugh Heather R. 1051 Gause Blvd Ste 260 Slidell LA 70458 20 02 1 none 1 2 2 30284510 89769761THE PHYSICIAN'S ALLIANCE CORP (TPAC) Epps Joseph M. 1051 Gause Blvd Suite 410 Slidell LA 70458 20 14 1 none 1 2 2 30284510 89769761Arvind Gopal MD Gopal Arvind MD 1051 Gause Blvd Ste 270 Slidell LA 70458 20 10 1 25-80 2 1 2 30284510 89769761THE PHYSICIAN'S ALLIANCE CORP (TPAC) Joubert Mary 1051 Gause Blvd Suite 280 Slidell LA 70458 20 2I 1 none 1 2 2 30284510 89769761THE PHYSICIAN'S ALLIANCE CORP (TPAC) Le Cuong 1051 Gause Blvd Suite 380 Slidell LA 70458 20 08 1 None 1 2 2 30284510 89769761THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reddy Gollamudi H. 1051 Gause Blvd Ste 225 Slidell LA 70458 35 65 1 none 1 2 2 30284510 89769761Gulf Coast Rheumatology Associates Sedrish Manelisa MD 1051 Gause Blvd Ste 440 Slidell LA 70458 20 2M 1 none 1 2 2 30284510 89769761Gulf Coast Rheumatology Associates Sedrish Phillip MD 1051 Gause Blvd Ste 440 Slidell LA 70458 20 41 1 >=18 1 2 2 30284510 89769761


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Shafor Robert 1051 Gause Blvd Ste 260 Slidell LA 70458 20 02 1 none 1 2 2 30284510 89769761THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sharp, III Clinton 1051 Gause Blvd Suite 380 Slidell LA 70458 20 08 1 None 1 2 2 30284510 89769761Medical & Surgical Eye Center Slagle David F MD 1051 Gause Blvd Ste 480 Slidell LA 70458 20 18 1 >=6 2 1 2 30284510 89769761THE PHYSICIAN'S ALLIANCE CORP (TPAC) Srinivas Dasarathy 1051 Gause Blvd Ste 290 Slidell LA 70458 20 10 1 none 1 2 2 30284510 89769761David F Slagle II MD Turla Maria Theresa MD 1051 Gause Blvd Ste 480 Slidell LA 70458 20 18 1 >=6 2 1 2 30284510 89769761CARDIOLOGY INSTITUTE INC Bethala Vasanth K. MD 1051 Gause Blvd., Ste. 320 Slidell LA 70458 20 06 1 none 1 2 2 30284510 89769761CARDIOLOGY INSTITUTE INC Echenique Victor MD 1051 Gause Blvd., Ste. 320 Slidell LA 70458 20 06 1 none 1 2 2 30284510 89769761CARDIOLOGY INSTITUTE INC Long William J. MD 1051 Gause Blvd., Ste. 320 Slidell LA 70458 20 06 1 none 1 2 2 30284510 89769761CARDIOLOGY INSTITUTE INC Pernenkil Ratnakar MD 1051 Gause Blvd., Ste. 320 Slidell LA 70458 20 06 1 none 1 2 2 30284510 89769761CARDIOLOGY INSTITUTE INC Thomas Ignatius MD 1051 Gause Blvd., Ste. 320 Slidell LA 70458 20 06 1 none 1 2 2 30284510 89769761Gulf South Pediatric Cardiology Cougle Allan MD 107 Smart Place Slidell LA 70458 20 1D 1 <=21 2 1 1 30285864 89774075THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dabdoub William H. 108 Smart Place Suite A Slidell LA 70458 32 48 1 none 1 2 2 30286139 89774071THE PHYSICIAN'S ALLIANCE CORP (TPAC) Watson Steven J. 108 Smart Place Suite A Slidell LA 70458 32 48 1 none 1 2 2 30286139 89774071ACADIAN CARE LLC Chrisman Pamela 113 Christain Lane Slidell LA 70458 78 08 1 >=18 1 2 2 30299942 89756789Audibel Hearing Healthcare Macione Michelle AUD 114 Village St Ste A Slidell LA 70458 34 64 1 None 2 1 2 30308947 89745130THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ahmad Safeer 1150 Robert Blvd Suite 340 Slidell LA 70458 20 06 1 none 1 2 2 30287248 89770961THE PHYSICIAN'S ALLIANCE CORP (TPAC) Casey Michael 1150 Robert Blvd Suite 100 Slidell LA 70458 20 08 1 None 1 2 2 30287248 89770961THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daftary Mahmoud 1150 Robert Blvd Ste 350 Slidell LA 70458 20 34 1 none 1 2 2 30287248 89770961THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guidry Frank 1150 Robert Blvd Suite 100 Slidell LA 70458 20 08 1 None 1 2 2 30287248 89770961THE PHYSICIAN'S ALLIANCE CORP (TPAC) Henry Miyoshi 1150 Robert Blvd Ste 100 Slidell LA 70458 20 08 1 None 1 2 2 30287248 89770961THE PHYSICIAN'S ALLIANCE CORP (TPAC) Keppell Frederick L. 1150 Robert Blvd Suite 100 Slidell LA 70458 20 20 1 none 1 2 1 30287248 89770961THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thomas Madaelil 1150 Robert Blvd Suite 340 Slidell LA 70458 20 06 1 none 1 2 2 30287248 89770961SCHUNIOR RICHARD J MD Schunior Richard J. MD, FACS 1150 Robert Blvd., Ste. 230 Slidell LA 70458 20 02 1 none 1 2 2 30287248 89770961BIRMINGHAM FRED L OD Birmingham Fred I. MD 1173 Robert Blvd Slidell LA 70458 28 88 1 none 1 2 1 30286541 89771267TAKE CARE HEALTH LOUISIANA 1260 Front Street Slidell LA 70458 78 08 1 none 1 2 2 30286061 89779179DELTA IMAGING LLC 1310 Gause Blvd Slidell LA 70458 20 30 1 none 1 2 2 30284932 89765569ST CHARLES COMMUNITY HEALTH CENTER 1340 14th St. Slidell LA 70458 72 9L 1 none 1 2 1 30283854 89768747ST CHARLES COMMUNITY HEALTH CENTER Dixit Madhuri MD 1340 14th St. Slidell LA 70458 20 37 1 <=18 1 2 1 30283854 89768747ST CHARLES COMMUNITY HEALTH CENTER Hadi Mohammed MD 1340 14th St. Slidell LA 70458 20 08 1 None 1 2 2 30283854 89768747ST CHARLES COMMUNITY HEALTH CENTER Huarcaya Erick MD 1340 14th St. Slidell LA 70458 20 08 1 None 1 2 1 30283854 89768747ST CHARLES COMMUNITY HEALTH CENTER Joseph Kevin O. MD 1340 14th St. Slidell LA 70458 20 08 1 None 1 2 1 30283854 89768747ST CHARLES COMMUNITY HEALTH CENTER Mardia Sudha MD 1340 14th St. Slidell LA 70458 20 08 1 None 1 2 1 30283854 89768747ST CHARLES COMMUNITY HEALTH CENTER Nachabe Moustafa MD 1340 14th St. Slidell LA 70458 20 37 1 <=18 1 2 1 30283854 89768747ST CHARLES COMMUNITY HEALTH CENTER Pitts Jane Bell NP 1340 14th St. Slidell LA 70458 78 08 1 None 1 2 2 30283854 89768747ST CHARLES COMMUNITY HEALTH CENTER Sadeghpour Bahram MD 1340 14th St. Slidell LA 70458 20 37 1 <=18 1 2 1 30283854 89768747CHILDREN'S INTERNATIONAL Claycomb Stephen MD 1346 Lindberg Dr. Stes. 7 & 8 Slidell LA 70458 20 37 1 <=18 1 2 1 30282838 89754257CHILDREN'S INTERNATIONAL Cohen Irwin MD 1346 Lindberg Dr. Stes. 7 & 8 Slidell LA 70458 20 37 1 <=18 1 2 1 30282838 89754257CHILDREN'S INTERNATIONAL Hernandez Eduardo MD 1346 Lindberg Dr. Stes. 7 & 8 Slidell LA 70458 20 29 1 none 1 2 1 30282838 89754257CHILDREN'S INTERNATIONAL Jeansonne Cornel MD 1346 Lindberg Dr. Stes. 7 & 8 Slidell LA 70458 20 37 1 <=18 1 2 1 30282838 89754257CHILDREN'S INTERNATIONAL Moody Kristi NP 1346 Lindberg Dr. Slidell LA 70458 78 08 1 >=18 1 2 1 30282838 89754257CHILDREN'S INTERNATIONAL Narumanchi Janani MD 1346 Lindberg Dr. Stes. 7 & 8 Slidell LA 70458 20 37 1 <=18 1 2 1 30282838 89754257CHILDREN'S INTERNATIONAL Plauche Andrea NP 1346 Lindberg Dr. Stes. 7 & 8 Slidell LA 70458 78 79 1 >=18 1 2 2 30282838 89754257CHILDREN'S INTERNATIONAL Pouw I.S. Victor MD 1346 Lindberg Dr. Stes. 7 & 8 Slidell LA 70458 20 2E 1 none 1 2 1 30282838 89754257CHILDREN'S INTERNATIONAL Wilson Ella NP 1346 Lindberg Dr. Stes. 7 & 8 Slidell LA 70458 78 08 1 >=18 1 2 1 30282838 89754257RESTORATIVE PROSTHETICS & ORT 1350 Lindberg Dr Slidell LA 70458 40 54 1 none 1 2 2 30282692 89754256Herbert Ichinose MD Ichinose Herbert MD 1365 Englewood Dr Slidell LA 70458 20 22 1 None 1 2 2 30283482 89761735CHILDREN'S INTERNATIONAL Claycomb Stephen MD 1430 Lindberg Drive Slidell LA 70458 20 37 1 <=18 1 2 1 30280911 89752548CHILDREN'S INTERNATIONAL Cohen Irwin MD 1430 Lindberg Drive Slidell LA 70458 20 37 1 <=18 1 2 1 30280911 89752548CHILDREN'S INTERNATIONAL Hernandez Eduardo MD 1430 Lindberg Drive Slidell LA 70458 20 29 1 none 1 2 1 30280911 89752548CHILDREN'S INTERNATIONAL Jeansonne Cornel MD 1430 Lindberg Drive Slidell LA 70458 20 37 1 <=18 1 2 1 30280911 89752548


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

CHILDREN'S INTERNATIONAL Moody Kristi NP 1430 Lindberg Drive Slidell LA 70458 78 08 1 >=18 1 2 1 30280911 89752548CHILDREN'S INTERNATIONAL Narumanchi Janani MD 1430 Lindberg Drive Slidell LA 70458 20 37 1 <=18 1 2 1 30280911 89752548CHILDREN'S INTERNATIONAL Plauche Andrea NP 1430 Lindberg Drive Slidell LA 70458 78 79 1 >=18 1 2 2 30280911 89752548CHILDREN'S INTERNATIONAL Pouw I.S. Victor MD 1430 Lindberg Drive Slidell LA 70458 20 2E 1 none 1 2 1 30280911 89752548CHILDREN'S INTERNATIONAL Wilson Ella NP 1430 Lindberg Drive Slidell LA 70458 78 08 1 >=18 1 2 1 30280911 89752548SOUTHERN MEDICAL & ADAPTIVE SOLUTIONS 1503 Gause Blvd., Ste. 104 Slidell LA 70458 40 54 1 none 1 2 2 30284532 89758296ALETA DECLOUET DeClouet Aleta 659 Brownswitch Rd. Slidell LA 70458 19 41 1 >=16 1 2 1 30310522 89752311LABCORP 700 GAUSE BLVD STE 102 SLIDELL LA 70458 20 30 1 none 1 1 2 30284916 89773686Quest Diagnostics 736 Gause Blvd Slidell LA 70458 20 30 1 none 1 1 2 30284910 89773388LINCARE INC 769 ROBERT BLVD SUITE 100 SLIDELL LA 70458 40 54 1 none 1 1 2 30295231 89764804RENE J PIGEON, OD Pigeon Rene J. 839 Robert Blvd. Slidell LA 70458 28 88 1 none 1 2 2 30294156 89766227THE PHYSICIAN'S ALLIANCE CORP (TPAC) McElveen Linda 85 Whisperwood Blvd Ste 2aa Slidell LA 70458 20 41 1 >=18 1 2 2 30311800 89756134KIDNEY & HYPERTENSION ASSOCIATES Powers David R. MD 877 Brownswitch Road Slidell LA 70458 20 2K 1 >=18 1 2 2 30310544 89745444LA Heart Center Arena Frank J MD 901 Gause Blvd 2nd Flr Slidell LA 70458 20 06 1 >=18 2 1 2 30284517 89771426LA Heart Center Bernstein Marc M MD 901 Gause Blvd 2nd Flr Slidell LA 70458 20 06 1 >=18 2 1 2 30284517 89771426LA Heart Center Hickey Keith G MD 901 Gause Blvd 2nd Flr Slidell LA 70458 20 06 1 >=18 2 1 2 30284517 89771426THE PHYSICIAN'S ALLIANCE CORP (TPAC) Iteld Bruce 901 Gause Blvd 2nd Floor Slidell LA 70458 20 06 1 none 1 2 1 30284517 89771426THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sharma Sushant 901 Gause Blvd 2nd Floor Slidell LA 70458 20 06 1 none 1 2 2 30284517 89771426THE PHYSICIAN'S ALLIANCE CORP (TPAC) Silverstein Jay MD 901 Gause Blvd 2nd Floor Slidell LA 70458 20 06 1 none 1 2 2 30284517 89771426LA Heart Center Stein Jeffrey J NP 901 Gause Blvd 2nd Flr Slidell LA 70458 78 87 1 >=18 2 1 2 30284517 89771426THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stumpf-hollister Debra 901 Gause Blvd Slidell LA 70458 19 08 1 None 1 2 2 30284517 89771426LA HEART CENTER Arena Frank MD 901 Gause Blvd., 2nd flr Slidell LA 70458 20 06 1 none 1 2 2 30284517 89771426LA HEART CENTER Bernstein Marc MD 901 Gause Blvd., 2nd flr Slidell LA 70458 20 06 1 none 1 2 2 30284517 89771426LA HEART CENTER Hickey Keith MD 901 Gause Blvd., 2nd flr Slidell LA 70458 20 06 1 none 1 2 2 30284517 89771426LA HEART CENTER Iteld Bruce MD 901 Gause Blvd., 2nd flr Slidell LA 70458 20 06 1 none 1 2 1 30284517 89771426LA HEART CENTER Sharma Sushant MD 901 Gause Blvd., 2nd flr Slidell LA 70458 20 06 1 none 1 2 2 30284517 89771426LA HEART CENTER Silverstein Jay MD 901 Gause Blvd., 2nd flr Slidell LA 70458 20 06 1 none 1 2 2 30284517 89771426LA HEART CENTER Stein Jeffrey NP 901 Gause Blvd., 2nd flr Slidell LA 70458 78 79 1 >=18 1 2 2 30284517 89771426THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thomas, Jr. Clinton L. 985 Robert Blvd Ste 105 Slidell LA 70458 20 16 1 >=16 1 2 1 30291383 89769068GARRETT MAYNARD E MD Garrett Maynard E. MD 985 Robert Blvd Suite 102 Slidell LA 70458 20 04 1 none 1 2 1 30291383 89769068THE PHYSICIAN'S ALLIANCE CORP (TPAC) Duffour Rory J. 1400 Hwy 190 W Slidell LA 70460 20 08 1 None 1 2 2 30297992 89783991CAN INC. Nassauer Charles A. OD 150 Northshore Blvd Slidell LA 70460 28 88 1 none 1 2 1 30306597 89825634WANDELL JENNIFER L OD Wandell Jennifer 167 Northshore Blvd. Slidell LA 70460 28 88 1 none 1 2 2 30308739 89825960Ochsner Clinic Borchers Stephen M. 2104 Highway 190 West Slidell LA 70460 28 88 1 none 1 2 2 30293761 89814195Ochsner Clinic Doneyhue Wendy J. 2104 Highway 190 West Slidell LA 70460 20 18 1 none 1 2 2 30293761 89814195Ochsner Clinic Searle C. Roger PT 2104 Highway 190 West Slidell LA 70460 20 08 1 None 1 2 2 30293761 89814195Ochsner Clinic Carter Tracie N. 2750 East Gause Blvd. Slidell LA 70461 20 37 1 <=18 1 2 2 30290519 89723759Ochsner Medical Center - Northshore 100 Medical Center Drive Slidell LA 70461 60 86 1 none 1 2 2 30285050 89742871Ochsner Clinic Au Henry Y. 100 Medical Center Drive Slidell LA 70461 91 05 1 none 1 2 2 30285050 89742871Ochsner Clinic Bishop Laurie Ann 100 Medical Center Drive Slidell LA 70461 20 30 1 none 1 2 2 30285050 89742871Ochsner Clinic Choe Ella U. 100 Medical Center Drive Slidell LA 70461 20 41 1 >=18 1 2 2 30285050 89742871Ochsner Clinic Collins Jared F. 100 Medical Center Drive Slidell LA 70461 20 41 1 >=18 1 2 2 30285050 89742871Ochsner Clinic Cortez Matthew 100 Medical Center Drive Slidell LA 70461 20 1C 1 none 1 2 1 30285050 89742871Ochsner Clinic Cousins Darren S. 100 Medical Center Drive Slidell LA 70461 20 05 1 none 1 2 2 30285050 89742871Ochsner Clinic Cousins Randolph E. 100 Medical Center Drive Slidell LA 70461 20 05 1 none 1 2 2 30285050 89742871Ochsner Clinic Donaldson, Jr. David J. 100 Medical Center Drive Slidell LA 70461 20 30 1 none 1 2 1 30285050 89742871Ochsner Clinic Hill Jason B. 100 Medical Center Drive Slidell LA 70461 20 41 1 >=18 1 2 2 30285050 89742871THE PHYSICIAN'S ALLIANCE CORP (TPAC) Labrie-brown Carmen L. 100 Medical Center Drive Slidell LA 70461 20 05 1 none 1 2 2 30285050 89742871Ochsner Clinic Landry, III William B. 100 Medical Center Drive Slidell LA 70461 20 05 1 none 1 2 2 30285050 89742871Ochsner Clinic McElveen Linda 100 Medical Center Drive Slidell LA 70461 20 41 1 >=18 1 2 2 30285050 89742871


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Monnat Paula M. 100 Medical Center Drive Slidell LA 70461 20 05 1 none 1 2 2 30285050 89742871Ochsner Clinic Morrison Geralynn G. 100 Medical Center Drive Slidell LA 70461 20 41 1 >=18 1 2 2 30285050 89742871Ochsner Clinic Sheeder Amy E. 100 Medical Center Drive Slidell LA 70461 20 41 1 >=18 1 2 2 30285050 89742871Ochsner Clinic Truxillo T. Michael 100 Medical Center Drive Slidell LA 70461 20 05 1 none 1 2 2 30285050 89742871EYECARE 2020 Notaroberto Neil F. 102 Medical Center Dr Suite 202 Slidell LA 70461 20 18 1 none 1 2 2 30285050 89742871John George Roheim MD Roheim John MD 105 Medical Center Ste 201 Slidell LA 70461 20 37 1 <21 1 1 1 30285042 89743188THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bolisay Crispin G. 105 Medical Center Dr Ste 304 Slidell LA 70461 20 2K 1 none 1 2 2 30285042 89743188THE PHYSICIAN'S ALLIANCE CORP (TPAC) Larcena Allan 105 Medical Center Dr Suite 301 Slidell LA 70461 20 41 1 >=18 1 2 1 30285042 89743188THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vigee Darren 105 Medical Center Dr Ste 302 Slidell LA 70461 32 48 1 none 1 2 1 30285042 89743188JOHN GEORGE ROHEIM, MD FAAP, AMPC Roheim John George MD, FAAP 105 Medical Center Dr. Ste 201 Slidell LA 70461 20 37 1 <=18 1 2 1 30285042 89743188PARR PROSTHETICS AND ORTHOTICS, INC 172 Commercial Square Slidell LA 70461 40 53 1 none 1 2 2 30287226 89740145GEAUX 2 PEDIATRICS LLC 181 Commercial Square Slidell LA 70461 40 54 1 none 1 2 2 30287134 89740462Slidell Ear, Nose, & Throat Associates Hebert Louis C. MD 1850 Gause Blvd Ste 301 Slidell LA 70461 20 04 1 none 1 2 2 30285134 89742877THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lew Christopher 1850 Gause Blvd Ste 201 Slidell LA 70461 20 05 1 none 1 2 2 30285134 89742877THE PHYSICIAN'S ALLIANCE CORP (TPAC) Metoyer Rand 1850 Gause Blvd Ste 201 Slidell LA 70461 20 05 1 none 1 2 2 30285134 89742877Slidell Ear, Nose, & Throat Associates Owens Robert E. MD 1850 Gause Blvd Ste 301 Slidell LA 70461 20 04 1 none 1 2 2 30285134 89742877Slidell Ear, Nose, & Throat Associates Pena Gerard E. MD 1850 Gause Blvd Ste 301 Slidell LA 70461 20 04 1 none 1 2 1 30285134 89742877THE PHYSICIAN'S ALLIANCE CORP (TPAC) Serrant Pedro 1850 Gause Blvd Ste 103 Slidell LA 70461 20 41 1 >=18 1 2 2 30285134 89742877LABCORP 1850 GAUSE BLVD E STE 101A SLIDELL LA 70461 20 30 1 none 1 1 2 30285134 89742877HIXSON MEREDITH JMD Hixson Meredith J. MD 1850 Gause Blvd Ste 203 Slidell LA 70461 20 16 1 >=16 1 2 1 30285134 89742877THE PHYSICIAN'S ALLIANCE CORP (TPAC) Beckwith Deanna 200 North Military Road Slidell LA 70461 35 65 1 none 1 2 2 30293341 89720188THE PHYSICIAN'S ALLIANCE CORP (TPAC) Burk Sally 200 North Military Road Slidell LA 70461 35 65 1 none 1 2 2 30293341 89720188THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cheshire Vincent 200 North Military Road Slidell LA 70461 35 65 1 none 1 2 2 30293341 89720188THE PHYSICIAN'S ALLIANCE CORP (TPAC) Higgins Tiffany 200 North Military Road Slidell LA 70461 35 65 1 none 1 2 2 30293341 89720188THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson Robyn 200 North Military Road Slidell LA 70461 35 65 1 none 1 2 2 30293341 89720188THE PHYSICIAN'S ALLIANCE CORP (TPAC) Teeter Craig 200 North Military Road Slidell LA 70461 35 65 1 none 1 2 2 30293341 89720188O'Byrne Eye Clinic Moncada Jennifer OD 2160 E Gause Blvd #101 Slidell LA 70461 28 88 1 None 2 1 2 30287399 89734599O'Byrne Eye Clinic O'Byrne Marilu MD 2160 E Gause Blvd Suite 101 Slidell LA 70461 20 18 1 none 1 2 2 30287399 89734599AUDIBEL HEARING HEALTHCARE 2238 E. Gause Blvd Slidell LA 70461 34 64 1 none 1 2 2 30288267 89731517THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dale Dennis 2240 Gause Blvd E Slidell LA 70461 20 29 1 none 1 2 2 30288293 89731423THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schuller Hans 2240 Gause Blvd E Slidell LA 70461 20 29 1 none 1 2 2 30288293 89731423NORTHLAKE EYE CENTER Benson Andrew MD 2243 Gause Blvd. East Slidell LA 70461 20 18 1 none 1 2 2 30288072 89731184NORTHLAKE EYE CENTER Hemelt Terrell M. MD 2243 Gause Blvd. East Slidell LA 70461 20 18 1 none 1 2 2 30288072 89731184THE PHYSICIAN'S ALLIANCE CORP (TPAC) Beck Robert J. 2250 E Gause Blvd Ste 302 Slidell LA 70461 30 35 1 none 1 2 2 30288427 89730959Northshore Cardiovascular Associate Banish Dorothy H MD 2360 Gause Blvd E Slidell LA 70461 20 06 1 >=19 2 1 2 30289360 89727791Northshore Cardiovascular Associate Morales Anthony MD 2360 Gause Blvd E Slidell LA 70461 20 06 1 >=19 2 1 2 30289360 89727791NORTHSHORE CARDIOVASCULAR ASSOCIATES Barrios Sergio MD 2360 Gause Blvd East Slidell LA 70461 20 06 1 none 1 2 2 30289360 89727791NORTHSHORE CARDIOVASCULAR ASSOCIATES Morales, Jr. Anthony MD 2360 Gause Blvd East Slidell LA 70461 20 06 1 none 1 2 2 30289360 89727791NORTHSHORE CARDIOVASCULAR ASSOCIATES Raymon Carol NP 2360 Gause Blvd East Slidell LA 70461 78 79 1 >=18 1 2 2 30289360 89727791Ochsner Clinic Braudt Steven M. 2370 E. Gause Blvd. Slidell LA 70461 19 37 1 <=18 1 2 1 30289382 89727713Ochsner Clinic Deeney Tara T. 2370 E. Gause Blvd. Slidell LA 70461 20 37 1 <=18 1 2 1 30289382 89727713Ochsner Clinic Mayer Jonette H. 2370 E. Gause Blvd. Slidell LA 70461 20 37 1 <=18 1 2 2 30289382 89727713Ochsner Clinic Mitchell Tara E. 2370 E. Gause Blvd. Slidell LA 70461 20 37 1 <=18 1 2 2 30289382 89727713Ochsner Clinic Seymour Mary L. 2370 E. Gause Blvd. Slidell LA 70461 20 37 1 <=18 1 2 2 30289382 89727713BITARS SPECIALTY CLINIC LLC Bitar Camille MD 2375 Gause Blvd. Slidell LA 70461 20 2I 1 >=18 1 2 2 30289132 89727574BITARS SPECIALTY CLINIC LLC Branton Donna ANP 2375 Gause Blvd. Slidell LA 70461 78 79 1 >=18 1 2 2 30289132 89727574Ochsner Clinic Berger Sheri 2750 E. Gause Blvd Slidell LA 70461 78 79 1 >=18 1 2 2 30290519 89723759Ochsner Clinic Hammond Ann S. 2750 E. Gause Blvd Slidell LA 70461 91 05 1 none 1 2 2 30290519 89723759Ochsner Clinic Humble Bobby J. 2750 E. Gause Blvd Slidell LA 70461 91 05 1 none 1 2 2 30290519 89723759Ochsner Clinic Lane Patricia J. 2750 E. Gause Blvd Slidell LA 70461 91 05 1 none 1 2 2 30290519 89723759


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Marble John A. 2750 E. Gause Blvd Slidell LA 70461 91 05 1 none 1 2 2 30290519 89723759Ochsner Clinic McCain Scott A. 2750 E. Gause Blvd Slidell LA 70461 91 05 1 none 1 2 2 30290519 89723759Ochsner Clinic Murphy Amanda R. 2750 E. Gause Blvd Slidell LA 70461 91 05 1 none 1 2 2 30290519 89723759Ochsner Clinic Palo Dana M. 2750 E. Gause Blvd Slidell LA 70461 91 05 1 none 1 2 2 30290519 89723759Ochsner Clinic Parret Christopher 2750 E. Gause Blvd Slidell LA 70461 91 05 1 none 1 2 2 30290519 89723759Ochsner Clinic Trahan Christian D. 2750 E. Gause Blvd Slidell LA 70461 91 05 1 none 1 2 2 30290519 89723759Ochsner Clinic Trainor Patrick J. 2750 E. Gause Blvd Slidell LA 70461 91 05 1 none 1 2 2 30290519 89723759Ochsner Clinic Abi-Samra Freddy M. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Andry, Jr. Malcom E. 2750 East Gause Blvd. Slidell LA 70461 20 10 1 none 1 2 2 30290519 89723759Ochsner Clinic Babo Mark E. 2750 East Gause Blvd. Slidell LA 70461 20 08 1 None 1 2 2 30290519 89723759Ochsner Clinic Baez Raymond 2750 East Gause Blvd. Slidell LA 70461 20 08 1 None 1 2 2 30290519 89723759Ochsner Clinic Beck David E. 2750 East Gause Blvd. Slidell LA 70461 20 02 1 none 1 2 2 30290519 89723759Ochsner Clinic Bernal Jose Alberto 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Bizette Greg A. 2750 East Gause Blvd. Slidell LA 70461 20 2H 1 none 1 2 2 30290519 89723759Ochsner Clinic Blessey Peter B. 2750 East Gause Blvd. Slidell LA 70461 20 20 1 none 1 2 2 30290519 89723759Ochsner Clinic Bober Robert M. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Boudreaux Lionel E. 2750 East Gause Blvd. Slidell LA 70461 28 88 1 none 1 2 2 30290519 89723759Ochsner Clinic Bowen John C. 2750 East Gause Blvd. Slidell LA 70461 20 2P 1 none 1 2 2 30290519 89723759Ochsner Clinic Bowie R. Earl 2750 East Gause Blvd. Slidell LA 70461 20 04 1 none 1 2 2 30290519 89723759Ochsner Clinic Breaux Patrick C. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Candal Francisco J. 2750 East Gause Blvd. Slidell LA 70461 20 41 1 >=18 1 2 2 30290519 89723759Ochsner Clinic Collins Tyrone J. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Daftary Mahmoud 2750 East Gause Blvd. Slidell LA 70461 20 34 1 none 1 2 2 30290519 89723759Ochsner Clinic Delaney, Jr. Patrick A. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Devraj Timothy 2750 East Gause Blvd. Slidell LA 70461 20 20 1 none 1 2 2 30290519 89723759Ochsner Clinic Dinshaw Homeyar K. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Elizardi David J. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Gilliland Yvonne E. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Hajjar Joseph D. 2750 East Gause Blvd. Slidell LA 70461 20 30 1 none 1 2 2 30290519 89723759Ochsner Clinic Hake Daniel H. 2750 East Gause Blvd. Slidell LA 70461 32 48 1 none 1 2 2 30290519 89723759Ochsner Clinic Hassett Cathryn C. 2750 East Gause Blvd. Slidell LA 70461 20 03 1 none 1 2 2 30290519 89723759Ochsner Clinic Jenkins James S. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Jolliff Natalia M. 2750 East Gause Blvd. Slidell LA 70461 35 65 1 none 1 2 2 30290519 89723759Ochsner Clinic Jones Deryk G. 2750 East Gause Blvd. Slidell LA 70461 20 20 1 none 1 2 2 30290519 89723759Ochsner Clinic Joshi Shobha N. 2750 East Gause Blvd. Slidell LA 70461 20 10 1 none 1 2 2 30290519 89723759Ochsner Clinic Karam Michael 2750 East Gause Blvd. Slidell LA 70461 20 02 1 none 1 2 2 30290519 89723759Ochsner Clinic Khatib Sammy 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Lavie, Jr. Carl J. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Lavigne, Jr. Michael E. 2750 East Gause Blvd. Slidell LA 70461 20 10 1 none 1 2 2 30290519 89723759Ochsner Clinic Leblanc, Jr. Richard T. 2750 East Gause Blvd. Slidell LA 70461 20 02 1 none 1 2 2 30290519 89723759Ochsner Clinic Lecce Michael D. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic LeFran Jose A. 2750 East Gause Blvd. Slidell LA 70461 20 41 1 >=18 1 2 2 30290519 89723759Ochsner Clinic Lessig Paul M. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Lowder, Jr. Carl E. 2750 East Gause Blvd. Slidell LA 70461 20 14 1 none 1 2 2 30290519 89723759Ochsner Clinic Luper Keith J. 2750 East Gause Blvd. Slidell LA 70461 32 48 1 none 1 2 2 30290519 89723759Ochsner Clinic McBurney Donald B. 2750 East Gause Blvd. Slidell LA 70461 20 30 1 none 1 2 2 30290519 89723759Ochsner Clinic McMullan, Jr. Paul W. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Mena Jose 2750 East Gause Blvd. Slidell LA 70461 20 33 1 none 1 2 2 30290519 89723759Ochsner Clinic Milani Richard V. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Nelson Twakor Onajefe S. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Newcomb James H. 2750 East Gause Blvd. Slidell LA 70461 20 08 1 None 1 2 2 30290519 89723759Ochsner Clinic Orejarena Leonardo A. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Randrup Eduardo R. 2750 East Gause Blvd. Slidell LA 70461 20 34 1 none 1 2 2 30290519 89723759Ochsner Clinic Rao Christopher G. 2750 East Gause Blvd. Slidell LA 70461 20 08 1 None 1 2 2 30290519 89723759Ochsner Clinic Reilly John P. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Restrepo Robert 2750 East Gause Blvd. Slidell LA 70461 20 30 1 none 1 2 2 30290519 89723759Ochsner Clinic Rich Gary M. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Romano Esteban O. 2750 East Gause Blvd. Slidell LA 70461 20 34 1 none 1 2 2 30290519 89723759Ochsner Clinic Rowan Darren M. 2750 East Gause Blvd. Slidell LA 70461 20 02 1 none 1 2 2 30290519 89723759Ochsner Clinic Shah Sangeeta B. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Skelton C. Lynn 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Swiger Johnny W. 2750 East Gause Blvd. Slidell LA 70461 20 16 1 >=16 1 2 1 30290519 89723759Ochsner Clinic Taylor Robert W. 2750 East Gause Blvd. Slidell LA 70461 20 08 1 None 1 2 2 30290519 89723759Ochsner Clinic Waddadar Jay 2750 East Gause Blvd. Slidell LA 70461 20 2E 1 none 1 2 2 30290519 89723759Ochsner Clinic Warren Frederic H. 2750 East Gause Blvd. Slidell LA 70461 20 20 1 none 1 2 1 30290519 89723759Ochsner Clinic White Christopher J. 2750 East Gause Blvd. Slidell LA 70461 20 06 1 none 1 2 2 30290519 89723759Ochsner Clinic Wolf Gary J. 2750 East Gause Blvd. Slidell LA 70461 20 02 1 none 1 2 2 30290519 89723759Ochsner Clinic Eckholdt Gregory J. 2750 East Gause Blvd. Slidell LA 70461 20 33 1 none 1 2 1 30290519 89723759Ochsner Clinic Mokry Daniel P. 2750 East Gause Blvd. Slidell LA 70461 20 16 1 >=16 1 2 1 30290519 89723759Ochsner Clinic Palo Matti W. 2750 East Gause Blvd. Slidell LA 70461 20 20 1 none 1 2 2 30290519 89723759NORTHSHORE DERMATOLOGY Tabor Eric N. MD 2780 Gause Blvd Ste A Slidell LA 70461 20 07 1 none 1 2 2 30290602 89723481EDWARD L DONALDSON DDS AND JILL DONALDSON DDS 2960 EAST GAUSE BOULEVARD SLIDELL LA 70461 32 48 1 none 1 1 2 30291090 89721807DIMITRI DERMATOLOGY Birkhoff Janice ANP 300 Gateway Dr Slidell LA 70461 78 79 1 >=18 1 2 2 30288276 89741632DIMITRI DERMATOLOGY DiMarco Marilyn ANP 300 Gateway Dr Slidell LA 70461 78 79 1 none 1 2 2 30288276 89741632DIMITRI DERMATOLOGY Dimitri Elizabeth DO 300 Gateway Dr Slidell LA 70461 19 07 1 none 1 2 1 30288276 89741632DIMITRI DERMATOLOGY Janeski Belinda 300 Gateway Dr Slidell LA 70461 78 79 1 none 1 2 2 30288276 89741632DIMITRI DERMATOLOGY McDonald Kate MD 300 Gateway Dr Slidell LA 70461 20 07 1 none 1 2 1 30288276 89741632DIMITRI DERMATOLOGY Mosadegh Mehdi MD 300 Gateway Dr Slidell LA 70461 20 07 1 none 1 2 1 30288276 89741632ANGELA DUTHU Duthu Angela S. MD 3020 East Gause Blvd. Slidell LA 70461 20 37 1 <=18 1 2 1 30291242 89721241HELEN E STEVENSON MD Foret Christina Heller RN CPNP 310 Gateway Dr Ste B Slidell LA 70461 93 37 1 <=18 1 2 2 30287972 89741658HELEN E STEVENSON MD Maraia Jennifer Hinrichsen MD 310 Gateway Dr Ste B Slidell LA 70461 20 37 1 <=18 1 2 2 30287972 89741658HELEN E STEVENSON MD Witcher Nancy Chauvet RN, CPNP 310 Gateway Dr Ste B Slidell LA 70461 93 37 1 <=18 1 2 1 30287972 89741658HELEN E STEVENSON MD Stevenson Helen Elizabeth MD 310 Gateway Dr. Ste B Slidell LA 70461 20 37 1 <=18 1 2 1 30287972 89741658Quest Diagnostics 370 Gateway Dr Ste B Slidell LA 70461 20 30 1 none 1 1 2 30286159 89741684Acadian Dermatology Weil Michael K MD 380 Gateway Dr Ste A Slidell LA 70461 20 07 1 None 2 1 1 30285854 89741672RESPIRATORY SERVICES INC 59038 Amber Street Slidell LA 70461 40 54 1 none 1 2 2 30285742 89733241MEDI-LEASE UNLIMITED 151 Fairview Dr. P.O. Box 8554 Mandeville LA 70470 40 54 1 none 1 2 2 30388322 90081040EYECARE 2020 Notaroberto Neil F. #2 Sanctuary Blvd Suite 303 Mandeville LA 70471 20 18 1 none 1 2 2 30385931 90108471NORTHSHORE EYE ASSOCIATES LLC Griener Eric D. MD 1101 N. Causeway Blvd Ste 1 Mandeville LA 70471 20 18 1 none 1 2 1 30382383 90091245NORTHSHORE EYE ASSOCIATES LLC Leger Brandy L. OD 1101 N. Causeway Blvd Ste 1 Mandeville LA 70471 28 88 1 none 1 2 2 30382383 90091245LA OPTICAL LLC 1101 N. Causeway Blvd., Ste. 1 Mandeville LA 70471 75 88 1 none 1 2 2 30382383 90091245DESPER BEATRICE S MD Desper Beatrice S. MD 1120 N. Causeway Blvd Ste 1 Mandeville LA 70471 20 16 1 >=16 1 2 2 30382679 90090505O'Byrne Eye Clinic Moncada Jennifer OD 1580 W Causeway Approach #3 Mandeville LA 70471 28 88 1 None 2 1 2 30392528 90101051O'Byrne Eye Clinic O'Byrne Marilu MD 1580 W. Causeway Approach Suite 3 Mandeville LA 70471 20 18 1 none 1 2 2 30392528 90101051ROBERT D ROSS MD APMC Ross Robert D. MD, FACS 1580 W. Causeway Approach Ste. 3 Mandeville LA 70471 20 18 1 none 1 2 1 30392528 90101051FIRST CHOICE DME 2180 3rd Street Mandeville LA 70471 40 54 1 none 1 2 2 30453576 90022361ADEMA VISION CLINIC Adema Patrick M. OD 2180 N. Causeway Blvd Mandeville LA 70471 28 88 1 none 1 2 1 30399406 90086445THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gaber Edward M. 231 St Ann Dr Ste 2 Mandeville LA 70471 20 41 1 >=18 1 2 2 30392964 90088508David L Samuel MD Samuel David L MD 233 St Ann Dr Ste 3 Mandeville LA 70471 20 34 1 None 2 1 2 30426939 90022740THE PHYSICIAN'S ALLIANCE CORP (TPAC) Quick Kenneth DPM 233 St Ann Drive Suite 4 Mandeville LA 70471 32 48 1 none 1 2 2 30407288 90104723


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Samuel David 233 St Anne Drive Suite 3 Mandeville LA 70471 20 34 1 none 1 2 2 30402352 90128422DAVID L. SAMUEL, M.D. Samuel David L. MD 233 St. Ann Drive Suite 3 Mandeville LA 70471 20 34 1 none 1 2 2 30426595 90022922THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chandler, Jr. Roderick 2330 N Causeway Blvd Mandeville LA 70471 20 20 1 none 1 2 2 30401223 90085895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Van Deventer Paul M. 2330 N Causeway Blvd Mandeville LA 70471 20 20 1 none 1 2 2 30401223 90085895TAKE CARE HEALTH LOUISIANA 2880 Hwy 190 Mandeville LA 70471 78 08 1 none 1 2 2 30385897 90079438EDWARD L DONALDSON DDS AND JILL DONALDSON DDS 2935 HIGHWAY 190 MANDEVILLE LA 70471 32 48 1 none 1 1 2 30386103 90079164Vision Optique Silbernagel Jeffrey OD 2997 Highway 190 Mandeville LA 70471 28 88 1 None 2 1 2 30386270 90079221Vision Optique Stanton Seth B OD 2997 Highway 190 Mandeville LA 70471 28 88 1 None 2 1 2 30386270 90079221VISION OPTIQUE INC Blanchard Anita OD 2997 Hwy 190 Mandeville LA 70471 28 88 1 none 1 2 2 30386270 90079221VISION OPTIQUE INC Gill Steve OD 2997 Hwy 190 Mandeville LA 70471 28 88 1 none 1 2 2 30386270 90079221VISION OPTIQUE INC Silbernagel Jeffrey OD 2997 Hwy 190 Mandeville LA 70471 28 88 1 none 1 2 1 30386270 90079221VISION OPTIQUE INC Stanton Seth OD 2997 Hwy 190 Mandeville LA 70471 28 88 1 none 1 2 2 30386270 90079221POLLET JR CLEMENT J OD Pollet C. J. OD 3421 Highway 190 Mandeville LA 70471 28 88 1 none 1 2 2 30387751 90080027FRANZ III ARTHUR J OD Franz Arthur J. MD 3601 Hwy 190 Ste B Mandeville LA 70471 28 88 1 none 1 2 2 30388422 90080444MOORE MEDICAL INC 4061 Highway 59, Ste. C Mandeville LA 70471 40 53 1 none 1 2 2 30409654 90041006Quest Diagnostics 4244 Highway 22 Mandeville LA 70471 20 30 1 none 1 1 2 30398348 90101809MOHAMMED YOUSUF Yousef Mohammed MD 4430 Highway 22 Mandeville LA 70471 20 08 1 None 1 2 1 30399875 90106360COASTAL ORTHOTICS & PROSTHETICS LLC Bass, III J. Gordan 4600 Hwy 22 Suite 1 Mandeville LA 70471 40 53 1 none 1 2 2 30401198 90110277COASTAL ORTHOTICS & PROSTHETICS LLC Northey Sean W. 4600 Hwy 22 Suite 1 Mandeville LA 70471 40 53 1 none 1 2 2 30401198 90110277CHOICE HOME MEDICAL EQUIPMENT Hughes W. Hayes 4966 Highway 22 Mandeville LA 70471 40 54 1 none 1 2 2 30404323 90119572ROMANO FRANK A OD Romano Frank A. OD 69160 Highway 59 Suite 2 Mandeville LA 70471 28 88 1 none 1 2 1 30443795 90041159WHITNEY OLIVER W OD Whitney Oliver W. OD 69160 HWY 59 Suite 2 Mandeville LA 70471 28 88 1 none 1 2 2 30443795 90041159HEALTH MANAGEMENT SERVICES Inc 69464 Highway 59 Suite 5 Mandeville LA 70471 40 54 1 none 1 2 2 30445951 90041152THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kluchin Ronald 784 Asbury Drive Mandeville LA 70471 20 41 1 >=18 1 2 2 30399857 90085551THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bradford, Jr. James 804 Heavens Dr Suite 105 Mandeville LA 70471 20 04 1 none 1 2 2 30401154 90116502THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guillot Richard 804 Heavens Dr Mandeville LA 70471 20 03 1 none 1 2 2 30401154 90116502THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mclaughlin Kevin E. 804 Heavens Drive Suite 105 Mandeville LA 70471 20 04 1 none 1 2 1 30401154 90116502PEDIATRIC GROUP OF ACADIANA, LLC Al-Boustani Rita MD 1002 Twelfth Street Lafayette LA 70501 20 37 1 <=18 1 2 2 30226828 92002349DYNAMIC ORTHOTIC SERVICES, INC Margaglio Sam 103 E. Pinhook Rd. Lafayette LA 70501 40 53 1 none 1 2 2 30213769 92008014LINCARE INC 1118 GENERAL MOUTON LAFAYETTE LA 70501 40 54 1 none 1 1 2 30212131 92008387VASCULAR ACCESS CENTER OF NORTH SHORE LA Gardner Philip MD 1340 Surrey St Ste 101 Lafayette LA 70501 20 02 1 >=18 1 2 2 30221745 91995983VASCULAR ACCESS CENTER OF NORTH SHORE LA McGurkin James MD 1340 Surrey St Ste 101 Lafayette LA 70501 20 30 1 >=16 1 2 2 30221745 91995983VASCULAR ACCESS CENTER OF NORTH SHORE LA Sanger Matthew MD 1340 Surrey St Ste 101 Lafayette LA 70501 20 41 1 >=18 1 2 2 30221745 91995983VASCULAR ACCESS CENTER OF NORTH SHORE LA Smith Kyle DO 1340 Surrey St Ste 101 Lafayette LA 70501 19 41 1 >=16 1 2 2 30221745 91995983PRECISION RADIOLOGY MANAGEMENT 201 W VERMILION ST STE 200 Lafayette LA 70501 20 30 1 none 1 2 2 30223915 92019970Hanger Prosthetics & Orthotics Inc. 417 Evangeline Thruway N.E. Lafayette LA 70501 40 53 1 none 1 1 2 30231276 92013221HANGER PROSTHETICS AND ORTHOTICS 417 Evangeline Thruway, NE Lafayette LA 70501 40 53 1 none 1 2 1 30231276 92013221LAWRENCE CHRISTY Christy Lawrence W. MD 600 E. 3rd St Lafayette LA 70501 20 37 1 <=18 1 2 1 30230476 92010199AGUILLARD SANDRA M. ST Aguillard Sandra Lee Moreau 707 Cedar Crest Court Lafayette LA 70501 39 71 1 none 1 2 2 30231315 92029804SWLA CENTER FOR HEALTH SERVICES 716 Hellen St. Lafayette LA 70501 72 9L 1 none 1 2 1 30241423 92025949SWLA CENTER FOR HEALTH SERVICES Foster Suzanne P. MD 716 Hellen St. Lafayette LA 70501 20 37 1 <=18 1 2 2 30241423 92025949SWLA CENTER FOR HEALTH SERVICES Graser Emily NP 716 Hellen St. Lafayette LA 70501 78 08 1 none 1 2 1 30241423 92025949SWLA CENTER FOR HEALTH SERVICES Somner John P. MD 716 Hellen St. Lafayette LA 70501 20 08 1 none 1 2 2 30241423 92025949SWLA CENTER FOR HEALTH SERVICES Wascomb Stephen M. MD 716 Hellen St. Lafayette LA 70501 20 08 1 none 1 2 2 30241423 92025949THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mwatibo James 850 N Pierce St Lafayette LA 70501 20 08 1 None 1 2 2 30243925 92018192THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith Carolyn 850 North Pierce Street Lafayette LA 70501 35 65 1 none 1 2 2 30243925 92018192THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daneshfar Bahman 917 General Mouton Ave Lafayette LA 70501 20 2J 1 none 1 2 1 30213523 92010118ONCOLOGICS INC DeLand M. Maitland MD 917 General Mouton Avenue Lafayette LA 70501 20 2J 1 none 1 2 2 30213523 92010118ONCOLOGICS INC Harwood Andrew R. MD 917 General Mouton Avenue Lafayette LA 70501 20 2J 1 none 1 2 1 30213523 92010118ONCOLOGICS INC Krawczyk Julian J. MD 917 General Mouton Avenue Lafayette LA 70501 20 2J 1 none 1 2 1 30213523 92010118


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mahoney Brent 917 General Mouton Avenue Lafayette LA 70501 20 2J 1 none 1 2 1 30213523 92010118ONCOLOGICS INC Prellop Perri B. MD 917 General Mouton Avenue Lafayette LA 70501 20 2J 1 none 1 2 1 30213523 92010118ONCOLOGICS INC Wilt Stephen R. MD 917 General Mouton Avenue Lafayette LA 70501 20 2J 1 none 1 2 1 30213523 92010118ONCOLOGICS INC Wortham Angela H. MD 917 General Mouton Avenue Lafayette LA 70501 20 2J 1 none 1 2 2 30213523 92010118ACADIANA FAMILY MEDICAL CENTER Williams Micheal Community Specialty Hospital 408 SE Evangeline T Lafayette LA 70501 20 08 1 none 1 2 1 30226287 92010415

Lafayette General Surgical Hospital 1000 W Pinhook Rd Lafayette LA 70503 60 86 1 None 1 2 2 30204193 92013682PARISH ANESTHESIA OF LAFAYETTE 1000 W. Pinhook Rd. Lafayette LA 70503 20 05 1 none 1 2 2 30204193 92013682ADVANCED MEDICAL SUPPLIES & SERVICES 1010 Coolidge St Lafayette LA 70503 40 54 1 none 1 2 1 30205776 92015927MANUEL MEDICAL CLINIC 104 Genevieve Dr Lafayette LA 70503 20 37 1 <=18 1 2 1 30184442 92067846MANUEL MEDICAL CLINIC Woodring James S. NP 104 Genevieve Dr Lafayette LA 70503 78 79 1 >=18 1 2 1 30184442 92067846Acadiana Retina Consultants Culotta Frank J MD 1101 S College Rd Ste 304 Lafayette LA 70503 20 18 1 None 1 2 2 30200138 92028036Acadiana Retina Consultants Gauthreaux Scott MD 1101 S College Rd Ste 304 Lafayette LA 70503 20 18 1 None 1 2 2 30200138 92028036ACADIANA REHABILITATION ASSOCIATES LaBorde Thomas C. 1101 S. College Rd., Ste. 206 Lafayette LA 70503 35 65 1 none 1 2 2 30200138 92028036THE PHYSICIAN'S ALLIANCE CORP (TPAC) Laborde Thomas 1101 South College 206 Lafayette LA 70503 35 65 1 none 1 2 2 30204513 92017132THE PHYSICIAN'S ALLIANCE CORP (TPAC) Abadco Doreen 114 Hospital Drive Lafayette LA 70503 20 05 1 none 1 2 2 30203019 92018535Parish Anesthesia West Bank, LLC AKKARA PAUL 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Aydell Brian George CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Belair Bridgette 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 1 30202684 92018004Parish Anesthesia West Bank, LLC Belair Charles 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Bellow Karen 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Bienasz Stanley Michael MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004Cancer Center of Acadiana at LGMC Blanchet Paulette MD 1211 Coolidge Blvd Ste 100 Lafayette LA 70503 20 2H 1 None 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Boraski Sheryl 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Bordelon Christopher Aaron CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Boyer Jeremy J. CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004Parish Anesthesia West Bank, LLC Brandt Thomas 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Breaux Jason P. CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Brennan Ann Marie 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 20 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Brockhoeft Jaqueline 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004Cancer Center of Acadiana at LGMC Cain Michael S MD 1211 Coolidge Blvd Ste 100 Lafayette LA 70503 20 2H 1 None 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Callaway Lauren 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004

Cancer Center of Acadiana at LGMC 1211 Coolidge Blvd Ste 100 Lafayette LA 70503 20 30 1 None 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Cannizzaro Anna 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 20 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Carriere Casey 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Castille Ross Victor CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004Parish Anesthesia West Bank, LLC Celebi-Aiken Fatima 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 1 30202684 92018004Parish Anesthesia West Bank, LLC Celentano Wayne 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 20 05 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Chappuis Cameron Charles CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004Parish Anesthesia West Bank, LLC Comarda Neal 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Cook Louise Segura CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Dabadie Virginia Guillory CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Dailey Alexis Broussard CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Ditta Melanie 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004Cancer Center of Acadiana at LGMC Donohue Rebecca NP 1211 Coolidge Blvd Ste 100 Lafayette LA 70503 78 87 1 None 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Dunn, II Michael Bernard MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Eagleton Bernard E. MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Ernst David J. CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Falgoust Marian 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004

Lafayette General Surgical Hospital

Cancer Center of Acadiana @ LGMC


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

PARISH ANESTHESIA OF LAFAYETTE Fontenot Kerwin J. MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Gaudin Rachel Lynn CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004Parish Anesthesia West Bank, LLC Goldenberg Thomas 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Guillot Trish Howell CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Hall Kathleen 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Hardy Kyle D. CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Havenar, Jr. James W. CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Hollier Royce Anthony CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004Parish Anesthesia West Bank, LLC House Glenn 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Hoz Philip 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Hux Paula 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Inuru Jayachandra R. MD 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 20 05 1 none 1 2 1 30202684 92018004Cancer Center of Acadiana at LGMC Johnson Deborah MD 1211 Coolidge Blvd Ste 100 Lafayette LA 70503 20 2H 1 None 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Johnson Jeffrey Lewis CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Ladart Mary 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE LaFleur Colby Paul CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lakshmiprasad Padumane 1211 Coolidge Blvd Suite 203 Lafayette LA 70503 20 06 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Landreneau Patrick Neil CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Langley Brigitte Hernandez CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE LaPointe-Hymel Dana CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE LeBlanc Yvette Launey CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Legnon Christopher Michael CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004Parish Anesthesia West Bank, LLC Levin Louis 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 20 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Lombardi Nicole 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Mampilly George Antony MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Mandell Steven Jess CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Martin Jennifer 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Mathes Karen 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC May Tadd 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Maynard Timothy S. CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Meaux Derek Lee CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004Cancer Center of Acadiana at LGMC Meza Luis A MD 1211 Coolidge Blvd Ste 100 Lafayette LA 70503 20 2H 1 None 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Mimeles Derek 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 20 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Montgomery Laura 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Odom Patrick Dickerson MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Olivier, III Roumay CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Palfrey Richard Gorgas MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004Cancer Center of Acadiana at LGMC Panelli Victoria E MD 1211 Coolidge Blvd Ste 100 Lafayette LA 70503 20 2H 1 None 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Patin Nicholas Charles CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Pearson Mary K. CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Powell Michael Shane CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Qunfoong Varaporn 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 1 30202684 92018004Cancer Center of Acadiana at LGMC Rainey John MD 1211 Coolidge Blvd Ste 100 Lafayette LA 70503 20 2H 1 None 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Respess Shannon 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Rue Byron Terry CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Rupe Brad D. MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Sampognaro Carmen 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Sanchez Maria Del Carmen MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Saulny Marie Christina MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Schnebelen Kyle CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Parish Anesthesia West Bank, LLC Sewell Gayle 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Sonnier Corey James CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Steele Barry Alan MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Steele Kenneth 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Stuprich Anthony V. CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004Allison Taylor MD OB Gyn Clinic Taylor Allison MD 1211 Coolidge Blvd Ste 404 Lafayette LA 70503 20 16 1 >=16 Female 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Thibodeaux Wayne Joseph MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Triay Melvin 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 20 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Vadlamudi Ramamohana 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Verlander Leo David MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Vickers Michael Kent CRNA 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 91 05 1 none 1 2 1 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Villien Marc Jacques MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004PARISH ANESTHESIA OF LAFAYETTE Villien Richard Patrick MD 1211 Coolidge Blvd Suite 302 Lafayette LA 70503 20 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Young Dinah 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 2 30202684 92018004Parish Anesthesia West Bank, LLC Zimmermann Christopher 1211 COOLIDGE BLVD SUITE 302 LAFAYETTE LA 70503 91 05 1 none 1 2 1 30202684 92018004Hospitalist Services of LGMC Carroll Robert J MD 1214 Coolidge Lafayette LA 70503 20 41 1 >=18 1 2 2 30202661 92018561Hospitalist Services of LGMC Castro Julio MD 1214 Coolidge Lafayette LA 70503 20 41 1 >=18 1 2 2 30202661 92018561Hospitalist Services of LGMC Fontenot Matthew S MD 1214 Coolidge Lafayette LA 70503 20 41 1 >=18 1 2 2 30202661 92018561Hospitalist Services of LGMC Guidry Norris MD 1214 Coolidge Lafayette LA 70503 20 08 1 None 1 2 2 30202661 92018561Hospitalist Services of LGMC Logue Amanda C MD 1214 Coolidge Lafayette LA 70503 20 41 1 >=18 1 2 2 30202661 92018561THE PHYSICIAN'S ALLIANCE CORP (TPAC) Carroll Robert 1214 Coolidge Blvd Lafayette LA 70503 20 41 1 >=18 1 2 2 30202661 92018561THE PHYSICIAN'S ALLIANCE CORP (TPAC) Castro Julio 1214 Coolidge Blvd Lafayette LA 70503 20 41 1 >=18 1 2 2 30202661 92018561THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fontenot Matthew 1214 Coolidge Blvd Lafayette LA 70503 20 41 1 >=18 1 2 2 30202661 92018561THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guidry Norris 1214 Coolidge Blvd Lafayette LA 70503 20 41 1 >=18 1 2 2 30202661 92018561

Lafayette General Medical Center 1214 Coolidge Blvd Lafayette LA 70503 60 86 1 None 1 2 2 30202661 92018561Chronic Care Team of LGMC Landry Michelle NP 1214 Coolidge Blvd Lafayette LA 70503 78 87 1 None 1 2 2 30202661 92018561THE PHYSICIAN'S ALLIANCE CORP (TPAC) Logue Amanda 1214 Coolidge Blvd Lafayette LA 70503 20 41 1 >=18 1 2 2 30202661 92018561PARISH ANESTHESIA OF LAFAYETTE 1214 Coolidge Blvd. Lafayette LA 70503 20 05 1 none 1 2 2 30202661 92018561Lafayette General Medical Ashraf Mufeed MD 1214 Coolidge St Lafayette LA 70503 20 1T 1 None 1 2 1 30202661 92018561Lafayette General Medical De Iulio David M MD 1214 Coolidge St Lafayette LA 70503 20 1C 1 None 1 2 1 30202661 92018561THE PHYSICIAN'S ALLIANCE CORP (TPAC) 1214 Coolidge Street Lafayette LA 70503 20 30 1 none 1 2 2 30202661 92018561THE PHYSICIAN'S ALLIANCE CORP (TPAC) 1214 Coolige Lafayette LA 70503 20 22 1 none 1 2 2 30198947 92025771

Domingue James N MD 1245 S College Rd Ste 100 Lafayette LA 70503 20 13 1 None 1 2 1 30199605 92024553THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barras Chris 1432 S. College Road Lafayette LA 70503 35 65 1 none 1 2 2 30201593 92018110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boullion Larry 1432 S. College Road Lafayette LA 70503 35 65 1 none 1 2 2 30201593 92018110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cloyd Harriet 1432 S. College Road Lafayette LA 70503 35 65 1 none 1 2 2 30201593 92018110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guidry Gary 1432 S. College Road Lafayette LA 70503 37 74 1 none 1 2 2 30201593 92018110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hebert Dalton 1432 S. College Road Lafayette LA 70503 35 65 1 none 1 2 2 30201593 92018110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hurley Jill 1432 S. College Road Lafayette LA 70503 37 74 1 none 1 2 2 30201593 92018110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Laperouse Paige 1432 S. College Road Lafayette LA 70503 37 74 1 none 1 2 2 30201593 92018110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Laperouse, III Expadie 1432 S. College Road Lafayette LA 70503 37 74 1 none 1 2 2 30201593 92018110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lobdell Mary 1432 S. College Road Lafayette LA 70503 29 71 1 none 1 2 2 30201593 92018110Jennifer Pugliese MD Pugliese Jennifer B MD 1460 S College Rd Lafayette LA 70503 20 16 1 >=16 Female 1 2 2 30201624 92017410Internal Medicine Clinic of Acadiana Alexander Michael MD 155 Hospital Dr Ste 402 Lafayette LA 70503 20 41 1 >=18 1 2 2 30203376 92019648

Goldware Stephen MD 155 Hospital Dr Ste 203 Lafayette LA 70503 20 14 1 None 1 2 2 30203376 92019648Internal Medicine Clinic of LGMC Jolivette Milton J MD 155 Hospital Dr Ste 402 Lafayette LA 70503 20 41 1 >=18 1 2 2 30203376 92019648Cardiology Specialists of Acadiana Kowalski Joseph MD 155 Hospital Dr #101 Lafayette LA 70503 20 06 1 >=12 1 2 2 30203376 92019648LEDOUX HAROLD W MD LeDoux Harold W. MD 155 Hospital Dr Ste 300 Lafayette LA 70503 20 18 1 none 1 2 2 30203376 92019648Cardiology Specialists of Acadiana Leleux Jon D MD 155 Hospital Dr #101 Lafayette LA 70503 20 06 1 >=12 1 2 2 30203376 92019648

Lafayette General Medical Center


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Brent Mahoney MD Mahoney Brent MD 155 Hospital Dr Ste 102 Lafayette LA 70503 20 30 1 None 1 2 1 30203376 92019648Internal Medicine Clinic of Acadiana Perez-Ruiz Juan MD 155 Hospital Dr Ste 402 Lafayette LA 70503 20 41 1 >=18 1 2 2 30203376 92019648Cardiology Specialists of Acadiana Simpson Stephen R MD 155 Hospital Dr #101 Lafayette LA 70503 20 06 1 >=12 1 2 2 30203376 92019648Internal Medicine Clinic of Acadiana Sullivan Maurice J MD 155 Hospital Dr Ste 402 Lafayette LA 70503 20 41 1 >=18 1 2 2 30203376 92019648Cardiology Specialists of Acadiana Theriot Cory D NP 155 Hospital Dr #101 Lafayette LA 70503 78 87 1 >=12 1 2 2 30203376 92019648JON D LELEUX MD APMC Leleux Jon D. MD 155 Hospital Dr #101 Lafayette LA 70503 20 06 1 none 1 2 2 30203376 92019648JON D LELEUX MD APMC Simpson Stephen R. MD 155 Hospital Dr #101 Lafayette LA 70503 20 06 1 none 1 2 2 30203376 92019648JON D LELEUX MD APMC Theriot Cory D. NP 155 Hospital Dr #101 Lafayette LA 70503 78 79 1 >=18 1 2 2 30203376 92019648BARONNE FOOT CENTER McGee Nolia M. 155 Hospital Dr Ste 302 Lafayette LA 70503 32 48 1 none 1 2 2 30203376 92019648BARONNE FOOT CENTER Smith George R. 155 Hospital Dr Ste 302 Lafayette LA 70503 32 48 1 none 1 2 1 30203376 92019648THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kowalski Joseph 155 Hospital Drive Suite 101 Lafayette LA 70503 20 06 1 none 1 2 2 30203376 92019648THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lagraize Christopher 155 Hospital Drive Suite 410 Lafayette LA 70503 20 2P 1 none 1 2 2 30203376 92019648THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leleux Jon D. 155 Hospital Drive Suite 101 Lafayette LA 70503 20 06 1 none 1 2 2 30203376 92019648THE PHYSICIAN'S ALLIANCE CORP (TPAC) Simpson Stephen 155 Hospital Drive Suite 101 Lafayette LA 70503 20 06 1 none 1 2 2 30203376 92019648BARONNE FOOT CENTER Baronne Lon M. 155 Hospital Drive, Ste 302 Lafayette LA 70503 32 48 1 none 1 2 2 30203376 92019648THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fei Richard 227 Bendel Drive Lafayette LA 70503 20 29 1 none 1 2 2 30200388 92017857THE PHYSICIAN'S ALLIANCE CORP (TPAC) Malek Fadi 227 Bendel Road Lafayette LA 70503 20 29 1 none 1 2 2 30200388 92017857PRATT TIFFANY M DC Pratt Tiffany M. 3213 Johnston St Lafayette LA 70503 30 35 1 none 1 2 1 30203117 92049508SYNERGY HOME CARE-ACADIANA REGION, INC 4023 Ambassador Caffery Pkwy Lafayette LA 70503 44 75 1 none 1 2 2 30166388 92060259THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campbell Mark 441 Heymann Blvd Lafayette LA 70503 20 06 1 none 1 2 2 30202986 92015996THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mayes Charles 441 Heymann Blvd Lafayette LA 70503 20 06 1 none 1 2 2 30202986 92015996SANDERS CRAIG M OD Sanders Craig M. 4432 B. Johnston St Lafayette LA 70503 28 88 1 none 1 2 1 30187792 92039762THE PHYSICIAN'S ALLIANCE CORP (TPAC) Salopek Stephen R. 457 Heymann Blvd Lafayette LA 70503 20 41 1 >=18 1 2 2 30202646 92016198THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lamkin Kerry PT 701 Robley Drive Suite 135 Lafayette LA 70503 35 65 1 none 1 2 2 30172885 92064087THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ducrest Paul 816 Harding St Lafayette LA 70503 35 65 1 none 1 2 2 30208732 92014840THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jones Scot 816 Harding St Lafayette LA 70503 35 65 1 none 1 2 2 30208732 92014840THE PHYSICIAN'S ALLIANCE CORP (TPAC) Soileau Jean 816 Harding St Lafayette LA 70503 35 65 1 none 1 2 2 30208732 92014840ANESTHESIOLOGY & PAIN CONSULTANTS Angelle Natalie CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 1 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Ardoin Reginald MD 901 Wilson Street Lafayette LA 70503 20 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Blanda Lauren CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Brandon Robinson CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Broussard Tanner CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Carriere Casey CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Daigle Melanie CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Dore Lynnette CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Dunn Christopher CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Gammel Scott MD 901 Wilson Street Lafayette LA 70503 20 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Greene Sy CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Guillory Jude CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 1 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Jennings Michael MD 901 Wilson Street Lafayette LA 70503 20 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Jindia Sanjiv MD 901 Wilson Street Lafayette LA 70503 20 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Judice Remi CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Kasarla Amarendar MD 901 Wilson Street Lafayette LA 70503 20 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Latiolais Michael CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 1 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Lee Darlene CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Manual Jennifer CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Martin John MD 901 Wilson Street Lafayette LA 70503 20 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Mitchell Matthew MD 901 Wilson Street Lafayette LA 70503 20 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Morgan April CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Papadakes Charles CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

ANESTHESIOLOGY & PAIN CONSULTANTS Passos Mary CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Pellerin Kiley CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Pesson Raymond CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Picard Guy CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Potier Marguerite CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Simon Paula CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ANESTHESIOLOGY & PAIN CONSULTANTS Starkovich Kristine CRNA 901 Wilson Street Lafayette LA 70503 91 05 1 none 1 2 2 30207790 92016411ACADIANA FAMILY MEDICAL CENTER Williams Micheal Lafayette General Hospital 1214 Coolidge Blvd Lafayette LA 70503 20 08 1 none 1 2 1 30202661 92018561HANGER PROSTHETICS AND ORTHOTICS 103 St Thomas St Lafayette LA 70506 40 53 1 none 1 2 1 30226410 92031490HANGER PROSTHETICS AND ORTHOTICS 103 St Thomas Street Lafayette LA 70506 40 53 1 none 1 2 1 30228054 92032872Hanger Prosthetics & Orthotics Inc. 103 St. Thomas Street Lafayette LA 70506 40 53 1 none 1 1 2 30226211 92057200THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cavanaugh Michael 105 Indenpendence Blvd Ste 3 Lafayette LA 70506 30 35 1 none 1 2 2 30223268 92036482THE PHYSICIAN'S ALLIANCE CORP (TPAC) Grimsley Connie 105 Indenpendence Blvd Ste 3 Lafayette LA 70506 30 35 1 none 1 2 2 30223268 92036482CONNIE CHIROPRATIC Grimsley Connie 105 Independence Blvd Suite 3 Lafayette LA 70506 30 35 1 none 1 2 2 30197599 92071982CAVANAUGH MICHAEL R., D.C. Cavanaugh Michael R. 105 Independence Blvd. Ste. 3 Lafayette LA 70506 30 35 1 none 1 2 2 30197599 92071982THE PHYSICIAN'S ALLIANCE CORP (TPAC) Champagne Kenneth 1103 W University Ave Lafayette LA 70506 20 02 1 none 1 2 2 30223065 92026448Quest Diagnostics 119 1/2 Arnould Blvd Lafayette LA 70506 20 30 1 none 1 1 2 30202096 92053504NEVILS PATRICIA M MD Nevils Patricia MD 1424 St. John St Lafayette LA 70506 20 16 1 >=16 1 2 2 30228543 92031269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Menard Darrin 202 Westgate Rd Lafayette LA 70506 20 08 1 None 1 2 2 30228393 92087211THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mire Geoffrey 202 Westgate Rd Lafayette LA 70506 20 08 1 None 1 2 2 30228393 92087211THE PHYSICIAN'S ALLIANCE CORP (TPAC) Devalcourt Ellen 2115 Dulles Drive Lafayette LA 70506 35 65 1 none 1 2 2 30210434 92092647THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leblanc Clark 2115 Dulles Drive Lafayette LA 70506 35 65 1 none 1 2 2 30210434 92092647THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcleod Max 2115 Dulles Drive Lafayette LA 70506 35 65 1 none 1 2 2 30210434 92092647THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meaux Maisie 2115 Dulles Drive Lafayette LA 70506 35 65 1 none 1 2 2 30210434 92092647THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sheffield Mike 2115 Dulles Drive Lafayette LA 70506 35 65 1 none 1 2 2 30210434 92092647THE PHYSICIAN'S ALLIANCE CORP (TPAC) Soignier Brian 2115 Dulles Drive Lafayette LA 70506 35 65 1 none 1 2 2 30210434 92092647THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sorrel Alix 2115 Dulles Drive Lafayette LA 70506 35 65 1 none 1 2 2 30210434 92092647THE PHYSICIAN'S ALLIANCE CORP (TPAC) Touchet Roxanne 2115 Dulles Drive Lafayette LA 70506 35 65 1 none 1 2 2 30210434 92092647THE PHYSICIAN'S ALLIANCE CORP (TPAC) Trahan Don 2115 Dulles Drive Lafayette LA 70506 35 65 1 none 1 2 2 30210434 92092647

Yazdi Masoud MD 224 St Landry St Ste 1C Lafayette LA 70506 20 39 1 >=16 1 2 2 30231786 92079229MASOUD YAZDI MD Yazdi Masoud MD 224 St. Landry St 1-C Lafayette LA 70506 20 2K 1 >=16 1 2 2 30208890 92035390ACADIAN VISION ASSOCIATES INC Mizelle W. Donner OD 225 N. College Rd Lafayette LA 70506 28 88 1 none 1 2 2 30208575 92040644THE PHYSICIAN'S ALLIANCE CORP (TPAC) Elais Darryl 2390 So Congress Street Lafayette LA 70506 20 16 1 >=16 1 2 2 30195923 92100351THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fabacher Philip 2390 So Congress Street Lafayette LA 70506 20 16 1 >=16 1 2 2 30195923 92100351THE PHYSICIAN'S ALLIANCE CORP (TPAC) Frey Daniel 2390 So Congress Street Lafayette LA 70506 20 02 1 none 1 2 2 30195923 92100351THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guidry Lonn 2390 So Congress Street Lafayette LA 70506 20 41 1 >=18 1 2 2 30195923 92100351THE PHYSICIAN'S ALLIANCE CORP (TPAC) Muthuswamy Murthy 2390 So Congress Street Lafayette LA 70506 20 08 1 none 1 2 2 30195923 92100351THE PHYSICIAN'S ALLIANCE CORP (TPAC) 2390 W Congress Lafayette LA 70506 20 05 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chastant Bradley 2390 W Congress Lafayette LA 70506 20 04 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daigle Jennifer 2390 W Congress Lafayette LA 70506 20 04 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dalal Geeta 2390 W Congress Lafayette LA 70506 20 06 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Harleson Samuel 2390 W Congress Lafayette LA 70506 20 02 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lugo Fabian 2390 W Congress Lafayette LA 70506 20 13 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Malek Fadi 2390 W Congress Lafayette LA 70506 20 29 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Malek Fadi 2390 W Congress Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walker Nancy 2390 W Congress Lafayette LA 70506 20 08 1 None 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ardoin Justin 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Baquet Bennett Todd 2390 W Congress St Lafayette LA 70506 20 2E 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bates Karen 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Blalock Anthony 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Broussard Alan MD 2390 W Congress St Lafayette LA 70506 20 08 1 None 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Broussard Alan 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cahill Kelly 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cardinale Francis 2390 W Congress St Lafayette LA 70506 20 16 1 >=16 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chappius Charles 2390 W Congress St Lafayette LA 70506 20 02 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Colligan Robert 2390 W Congress St Lafayette LA 70506 20 08 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Curry Karen G. 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545

Dahr Nahia MD 2390 W Congress St Lafayette LA 70506 20 37 1 <=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dahr Nahla 2390 W Congress St Lafayette LA 70506 20 37 1 <=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dibbs Vallee Monique 2390 W Congress St Lafayette LA 70506 20 37 1 <=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fei Richard 2390 W Congress St Lafayette LA 70506 20 29 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fei Richard 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guidry Jimmy 2390 W Congress St Lafayette LA 70506 20 37 1 <=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Harrington Melisa 2390 W Congress St Lafayette LA 70506 20 2K 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Harwood Andrew 2390 W Congress St Lafayette LA 70506 20 2J 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Howes Richard 2390 W Congress St Lafayette LA 70506 20 37 1 <=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hubbell Gerald 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Humble Kent 2390 W Congress St Lafayette LA 70506 20 08 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Joseph Jeffrey 2390 W Congress St Lafayette LA 70506 20 04 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kretschmer Theodore 2390 W Congress St Lafayette LA 70506 20 37 1 <=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lagraize Tami 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lakshmiprasad Leela 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lakshmiprasad Padumane 2390 W Congress St Lafayette LA 70506 20 06 1 none 1 2 1 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lamarche Maximo 2390 W Congress St Lafayette LA 70506 20 2K 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leblanc Leanne L. 2390 W Congress St Lafayette LA 70506 20 08 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Louis Charles H. 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Massengale William T. 2390 W Congress St Lafayette LA 70506 20 07 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mata Jose 2390 W Congress St Lafayette LA 70506 20 08 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mccormick Louis H. 2390 W Congress St Lafayette LA 70506 20 08 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mire Louis 2390 W Congress St Lafayette LA 70506 20 08 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moncada Lainie 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nevils Bobby 2390 W Congress St Lafayette LA 70506 20 16 1 >=16 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nijjar Vikram 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Noel Phillip 2390 W Congress St Lafayette LA 70506 20 04 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Saenz Rolando 2390 W Congress St Lafayette LA 70506 20 41 1 >=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sharma Sarita 2390 W Congress St Lafayette LA 70506 20 1C 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stellingworth Mark A. 2390 W Congress St Lafayette LA 70506 20 06 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Theriot Jeanne 2390 W Congress St Lafayette LA 70506 20 08 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thibodeaux John 2390 W Congress St Lafayette LA 70506 20 08 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thomas Mary 2390 W Congress St Lafayette LA 70506 20 37 1 <=18 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vargus Juan 2390 W Congress St Lafayette LA 70506 20 16 1 >=16 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barrios Dave J. 2390 W Congress Street Lafayette LA 70506 20 02 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Harkrider William W. 2390 W Congress Street Lafayette LA 70506 20 02 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stellingworth Mark A. 2390 W Congress Street Lafayette LA 70506 20 06 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Helmcke Frederick 2390 W. Congress Lafayette LA 70506 20 06 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Helmcke Frederick R. 2390 W. Congress Lafayette LA 70506 20 06 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stueben Eugene T. 2390 W. Congress Lafayette LA 70506 20 10 1 none 1 2 2 30215298 92046545THE PHYSICIAN'S ALLIANCE CORP (TPAC) Borrero Elizabeth 2390 W. Congress Street Lafayette LA 70506 20 2I 1 none 1 2 2 30215298 92046545

ST MARTIN PARISH SCHOOL-BASED HEALTH CENTERS (SBHC)

ST MARTIN PARISH SCHOOL- BASED HEALTH CENTERS (SBHC)


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hanks Jason 245 N. College Road Lafayette LA 70506 35 65 1 none 1 2 2 30208689 92040774THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hite David 245 N. College Road Lafayette LA 70506 35 65 1 none 1 2 2 30208689 92040774THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schexneider Malton 245 N. College Road Lafayette LA 70506 35 65 1 none 1 2 2 30208689 92040774THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allie David 2730 Ambassador Caffery Pkwy Ste 202a Lafayette LA 70506 20 33 1 none 1 2 1 30194382 92075326THE REGIONAL MEDICAL CENTER OF ACADIANA (HCA) 2810 Ambassador Caffery Pkwy Lafayette LA 70506 60 86 1 none 1 1 1 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Angelle Natalie CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 1 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Ardoin Reginald MD 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 20 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Blanda Lauren CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Brandon Robinson CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Broussard Tanner CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Carriere Casey CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Daigle Melanie CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Dore Lynnette CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Dunn Christopher CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Gammel Scott MD 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 20 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Greene Sy CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Guillory Jude CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 1 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Jennings Michael MD 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 20 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Jindia Sanjiv MD 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 20 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Judice Remi CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Kasarla Amarendar MD 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 20 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Latiolais Michael CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 1 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Lee Darlene CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Manual Jennifer CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Martin John MD 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 20 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Mitchell Matthew MD 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 20 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Morgan April CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Papadakes Charles CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Passos Mary CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Pellerin Kiley CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Picard Guy CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Potier Marguerite CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Simon Paula CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295ANESTHESIOLOGY & PAIN CONSULTANTS Starkovich Kristine CRNA 2810 Ambassador Caffery Pkwy. Lafayette LA 70506 91 05 1 none 1 2 2 30192491 92075295THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ashkar Ziad 300 West St Mary Blvd Lafayette LA 70506 20 2K 1 none 1 2 2 30215851 92023378THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gupta Akshey 300 West St Mary Blvd Lafayette LA 70506 20 2K 1 none 1 2 2 30215851 92023378THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mendez Carols 300 West St Mary Blvd Lafayette LA 70506 20 2K 1 none 1 2 2 30215851 92023378ONCOLOGICS INC DeLand M. Maitland MD 413 St. Landry Street Lafayette LA 70506 20 2J 1 none 1 2 2 30194300 92071277ONCOLOGICS INC Harwood Andrew R. MD 413 St. Landry Street Lafayette LA 70506 20 2J 1 none 1 2 1 30194300 92071277ONCOLOGICS INC Krawczyk Julian J. MD 413 St. Landry Street Lafayette LA 70506 20 2J 1 none 1 2 1 30194300 92071277ONCOLOGICS INC Prellop Perri B. MD 413 St. Landry Street Lafayette LA 70506 20 2J 1 none 1 2 1 30194300 92071277ONCOLOGICS INC Wilt Stephen R. MD 413 St. Landry Street Lafayette LA 70506 20 2J 1 none 1 2 1 30194300 92071277ONCOLOGICS INC Wortham Angela H. MD 413 St. Landry Street Lafayette LA 70506 20 2J 1 none 1 2 2 30194300 92071277THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chu Uyen 4212 W Congress St Ste 2400 Lafayette LA 70506 20 02 1 none 1 2 2 30196105 92075654THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cunningham Carson C. 4212 W Congress St Ste 2400 Lafayette LA 70506 20 02 1 none 1 2 2 30196105 92075654THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stevens Gary 4212 W Congress St Ste 2400 Lafayette LA 70506 20 02 1 none 1 2 2 30196105 92075654SOUTHWEST MEDICAL CENTER MULTISPECIALTY GROUP McLain Elizabeth MD 4212 W. Congress Suite 2400D Lafayette LA 70506 20 08 1 none 1 1 2 30196105 92075654SOUTHWEST MEDICAL CENTER MULTISPECIALTY GROUP Drew Otis MD 4212 W. Congress St. Suite 1850 Lafayette LA 70506 20 20 1 none 1 1 2 30196105 92075654SOUTHWEST MEDICAL CENTER MULTISPECIALTY GROUP Maraist, Jr. David V. DPM 4212 W. Congress St. Suite 2300A Lafayette LA 70506 32 48 1 none 1 1 2 30196105 92075654SOUTHWEST MEDICAL CENTER MULTISPECIALTY GROUP Lirtzman Mitchell MD 4212 W. Congress St. Suite 3200 Lafayette LA 70506 20 33 1 none 1 1 2 30196105 92075654


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SOUTHWEST MEDICAL CENTER MULTISPECIALTY GROUP Wyatt Charles MD 4212 W. Congress St. Suite 3200 Lafayette LA 70506 20 33 1 none 1 1 2 30196105 92075654SOUTHWEST MEDICAL CENTER MULTISPECIALTY GROUP Gautam Indira MD 4212 W. Congress Street Ste 2300B Lafayette LA 70506 20 08 1 none 1 1 2 30196105 92075654SOUTHWEST MEDICAL CENTER MULTISPECIALTY GROUP Pillette Cassandra MD 4212 W. Congress Street Ste 2300A-1 Lafayette LA 70506 20 08 1 none 1 1 2 30196105 92075654SOUTHWEST MEDICAL CENTER MULTISPECIALTY GROUP 4212 W. Congress, Ste. 2400D Lafayette LA 70506 20 08 1 none 1 1 2 30196105 92075654PREMIER MEDICAL EQUIP INC 453 Bertrand Dr Lafayette LA 70506 40 54 1 none 1 2 1 30210012 92043866THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lasseigne Kevin 501 W St. Mary Blvd Suite416 Lafayette LA 70506 35 65 1 none 1 2 2 30216738 92025080THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brierre Joseph 501 W. St. Mary Blvd Suite 200 Lafayette LA 70506 20 2H 1 none 1 2 1 30216738 92025080THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cole James 501 W. St. Mary Blvd Suite 200 Lafayette LA 70506 20 2H 1 none 1 2 1 30216738 92025080THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rinaldi David 501 W. St. Mary Blvd Ste 200 Lafayette LA 70506 20 2H 1 none 1 2 1 30216738 92025080THE PHYSICIAN'S ALLIANCE CORP (TPAC) Roden Karen B 501 W. St. Mary Blvd Suite 200 Lafayette LA 70506 20 2H 1 none 1 2 1 30216738 92025080Acadia Foot Care Grizzaffi Jeffery R DPM 601 W St Mary Blvd Ste 106 Lafayette LA 70506 32 48 1 None 1 2 2 30217270 92025814Acadia Foot Care Vierra Bernard A DPM 601 W St Mary Blvd Ste 106 Lafayette LA 70506 32 48 1 None 1 2 2 30217270 92025814THE PHYSICIAN'S ALLIANCE CORP (TPAC) Perry Adam T. 601 W St Marys Blvd Suite 308 Lafayette LA 70506 20 20 1 none 1 2 2 30217270 92025814KAREN R SMITH Smith Karen R. MD 601 W. St. Mary Blvd Ste 403 Lafayette LA 70506 20 41 1 >=18 1 2 2 30217270 92025814THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lejeune Robert 610 Guilbeau Road Ste A Lafayette LA 70506 30 35 1 none 1 2 2 30200273 92072756EARL WASHINGTON JR, MD Washington, Jr. Earl MD 611 St. Landry St. Lafayette LA 70506 20 10 1 none 1 2 2 30194155 92087300ACADIANA FAMILY MEDICAL CENTER Williams Micheal 611 St. Landry Street Lafayette LA 70506 20 08 1 none 1 2 1 30214886 92077787Madeline Powers, CRM, LLC Powers Madeline Gentle Choices Birth Center 1424 St. John St. Lafayette LA 70506 90 16 1 >=16 1 2 2 30206722 92043771BRIAN GRANGER Granger Brian K. MD 201 W. Gloria Switch Rd Ste I Lafayette LA 70507 20 08 1 None 1 2 2 30295750 92029586THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moore Patrick 3400 Moss Street Lafayette LA 70507 20 08 1 None 1 2 1 30266150 92007967Charles H Louis MD Louis Charles MD 3911 Moss St Lafayette LA 70507 20 41 1 >=13 1 2 2 30277588 92008020THE PHYSICIAN'S ALLIANCE CORP (TPAC) Williams Gerard K. 901 Gloria Switch Rd Lafayette LA 70507 20 41 1 >=18 1 2 1 30297681 92046769THE PHYSICIAN'S ALLIANCE CORP (TPAC) Abraham Matthew 100 Asma Blvd, Bldg 1 Suite 205 Lafayette LA 70508 20 08 1 None 1 2 1 30185035 92015780THE PHYSICIAN'S ALLIANCE CORP (TPAC) Franklin Robert 101 B Energy Parkway Lafayette LA 70508 35 65 1 none 1 2 2 30137149 92028639ANESTHESIOLOGY & PAIN CONSULTANTS Angelle Natalie CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 1 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Ardoin Reginald MD 1101 Kaliste Saloom Rd. Lafayette LA 70508 20 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Blanda Lauren CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Brandon Robinson CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Broussard Tanner CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Carriere Casey CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Daigle Melanie CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Dore Lynnette CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Dunn Christopher CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Gammel Scott MD 1101 Kaliste Saloom Rd. Lafayette LA 70508 20 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Greene Sy CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Guillory Jude CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 1 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Jennings Michael MD 1101 Kaliste Saloom Rd. Lafayette LA 70508 20 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Jindia Sanjiv MD 1101 Kaliste Saloom Rd. Lafayette LA 70508 20 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Judice Remi CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Kasarla Amarendar MD 1101 Kaliste Saloom Rd. Lafayette LA 70508 20 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Latiolais Michael CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 1 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Lee Darlene CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Manual Jennifer CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Martin John MD 1101 Kaliste Saloom Rd. Lafayette LA 70508 20 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Mitchell Matthew MD 1101 Kaliste Saloom Rd. Lafayette LA 70508 20 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Morgan April CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Papadakes Charles CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Passos Mary CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Pellerin Kiley CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Picard Guy CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522


LOI Contract STP*

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Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

ANESTHESIOLOGY & PAIN CONSULTANTS Potier Marguerite CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Simon Paula CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Starkovich Kristine CRNA 1101 Kaliste Saloom Rd. Lafayette LA 70508 91 05 1 none 1 2 2 30176863 92027522ANESTHESIOLOGY & PAIN CONSULTANTS Angelle Natalie CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 1 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Ardoin Reginald MD 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 20 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Blanda Lauren CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Brandon Robinson CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Broussard Tanner CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Carriere Casey CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Daigle Melanie CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Dore Lynnette CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Dunn Christopher CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Gammel Scott MD 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 20 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Greene Sy CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Guillory Jude CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 1 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Jennings Michael MD 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 20 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Jindia Sanjiv MD 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 20 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Judice Remi CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Kasarla Amarendar MD 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 20 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Latiolais Michael CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 1 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Lee Darlene CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Manual Jennifer CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Martin John MD 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 20 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Mitchell Matthew MD 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 20 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Morgan April CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Papadakes Charles CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Passos Mary CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Pellerin Kiley CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Pesson Raymond CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Picard Guy CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Potier Marguerite CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Simon Paula CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564ANESTHESIOLOGY & PAIN CONSULTANTS Starkovich Kristine CRNA 1103 Kaliste Saloom Rd. Ste. 304 Lafayette LA 70508 91 05 1 none 1 2 2 30176734 92027564THE PHYSICIAN'S ALLIANCE CORP (TPAC) Arceneaux Casey 112 Republic Avenue E & F Lafayette LA 70508 35 65 1 none 1 2 2 30160293 92043918THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kramer Stephen 112 Republic Avenue E & F Lafayette LA 70508 35 65 1 none 1 2 2 30160293 92043918THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sellers James 112 Republic Avenue E & F Lafayette LA 70508 35 65 1 none 1 2 2 30160293 92043918Family Health Plaza of LGMC Khan Farha MD 1216 Camellia Blvd Lafayette LA 70508 20 08 1 None 1 2 2 30175522 92042341Family Health Plaza of LGMC Larrison James C MD 1216 Camellia Blvd Lafayette LA 70508 20 08 1 None 1 2 2 30175522 92042341Family Health Plaza of LGMC Larrison Sherlyn B MD 1216 Camellia Blvd Lafayette LA 70508 20 08 1 None 1 2 2 30175522 92042341Family Health Plaza of LGMC Perron Andre K MD 1216 Camellia Blvd Lafayette LA 70508 20 08 1 None 1 2 2 30175522 92042341ACADIAN AMBULANCE SERVICE Burnell Chuck MD 130 E. Kaliste Saloom Lafayette LA 70508 51 59 1 none 1 2 1 30191397 92011816Keith Colomb MD Colomb Keith A MD 200 Beaullieau Dr Bldg 5 Lafayette LA 70508 20 02 1 None 1 2 2 30162923 92045290THE PHYSICIAN'S ALLIANCE CORP (TPAC) Colomb Keith 200 Beaullieu Drive Bldg 5 Lafayette LA 70508 20 02 1 none 1 2 2 30162923 92045290J BRENT PRATHER MD APMC Prather Jonathan Brent MD 200 Petroleum Drive Lafayette LA 70508 20 03 1 none 1 2 2 30180300 92007700J BRENT PRATHER MD APMC Reed Kathryn B. CPNP 200 Petroleum Drive Lafayette LA 70508 78 79 1 >=18 1 2 1 30180300 92007700HEALTH MANAGEMENT SERVICES Inc 2014 W. Pinhook Rd., Ste. 500 Lafayette LA 70508 40 54 1 none 1 2 2 30187025 92012432LABCORP 217 LA RUE FRANCE LAFAYETTE LA 70508 20 30 1 none 1 1 2 30194530 92013366Apria Healthcare, Inc. 2419 Ssouth College Rd Lafayette LA 70508 40 54 1 none 1 1 2 30186648 92011998THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fruge, Jr. Bernard 320 Settlers Trace Blvd Lafayette LA 70508 20 03 1 none 1 2 1 30172300 92033700Allergy, Asthma & Immunology Center Joseph Bina MD 320 Settlers Trace Blvd Lafayette LA 70508 20 03 1 None 1 2 1 30172300 92033700


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ALLERGY ASTHMA IMMUNOLOGY CEN Fruge, Jr. Bernard MD 320 Settlers Trace Blvd, Lafayette LA 70508 20 03 1 none 1 2 1 30172300 92033700ALLERGY ASTHMA IMMUNOLOGY CEN Joseph Bina E. MD 320 Settlers Trace Blvd. Lafayette LA 70508 20 03 1 none 1 2 1 30172300 92033700

Guidry Lynn MD 3554 W Pinhook Rd Lafayette LA 70508 20 08 1 None 1 2 2 30160932 91991690PEDIATRIC GROUP OF ACADIANA, LLC Abdel-Sayed Myriam A. MD 401 Youngsville Hwy Suite 100 Lafayette LA 70508 20 37 1 <=18 1 2 1 30156807 91990883THE PHYSICIAN'S ALLIANCE CORP (TPAC) Atwi Jibran MD 401 Youngsville Hwy Ste 100 Lafayette LA 70508 20 03 1 none 1 2 2 30156807 91990883PEDIATRIC GROUP OF ACADIANA, LLC Atwi Jibran E. MD 401 Youngsville Hwy Suite 100 Lafayette LA 70508 20 37 1 <=18 1 2 1 30156807 91990883PEDIATRIC GROUP OF ACADIANA, LLC Bandaru Kiranmai MD 401 Youngsville Hwy Suite 100 Lafayette LA 70508 20 37 1 <=18 1 2 2 30156807 91990883PEDIATRIC GROUP OF ACADIANA, LLC Papp Laszlo MD 401 Youngsville Hwy Suite 100 Lafayette LA 70508 20 37 1 <=18 1 2 1 30156807 91990883PEDIATRIC GROUP OF ACADIANA, LLC Yerasi Srinivasa MD 401 Youngsville Hwy Suite 100 Lafayette LA 70508 20 37 1 <=18 1 2 2 30156807 91990883ALFREDO LEBRON Lebron-Berges Alfredo MD 4540 Ambassador Caffery Pkwy St B130 Lafayette LA 70508 20 37 1 <=18 1 2 1 30155439 92047360LAFAYETTE OB HOSPITALISTS LLC 4600 Ambassador Caffery Pkwy Lafayette LA 70508 20 16 1 >=16 1 1 2 30154177 92045831WOMEN'S AND CHILDREN'S HOSPITAL 4600 Ambassador Caffery Pkwy Lafayette LA 70508 60 86 1 none 1 1 2 30154177 92045831LAFAYETTE OB HOSPITALISTS LLC Alfred Virginia MD 4600 Ambassador Caffery Pkwy Lafayette LA 70508 20 16 1 >=16 1 1 2 30154177 92045831LAFAYETTE OB HOSPITALISTS LLC Barnes Donald MD 4600 Ambassador Caffery Pkwy Lafayette LA 70508 20 16 1 >=16 1 1 2 30154177 92045831LAFAYETTE OB HOSPITALISTS LLC Carey Floyd Thomas MD 4600 Ambassador Caffery Pkwy Lafayette LA 70508 20 16 1 >=16 1 1 2 30154177 92045831LAFAYETTE OB HOSPITALISTS LLC Dean Rashonda MD 4600 Ambassador Caffery Pkwy Lafayette LA 70508 20 16 1 >=16 1 1 2 30154177 92045831LAFAYETTE OB HOSPITALISTS LLC Ghafar Mohamed A. MD 4600 Ambassador Caffery Pkwy Lafayette LA 70508 20 16 1 >=16 1 1 2 30154177 92045831LAFAYETTE OB HOSPITALISTS LLC Johns Robert MD 4600 Ambassador Caffery Pkwy Lafayette LA 70508 20 16 1 >=16 1 1 2 30154177 92045831LAFAYETTE OB HOSPITALISTS LLC Middleton Jaime MD 4600 Ambassador Caffery Pkwy Lafayette LA 70508 20 16 1 >=16 1 1 2 30154177 92045831LAFAYETTE OB HOSPITALISTS LLC Moon Robert MD 4600 Ambassador Caffery Pkwy Lafayette LA 70508 20 16 1 >=16 1 1 2 30154177 92045831LAFAYETTE OB HOSPITALISTS LLC Shah Swati MD 4600 Ambassador Caffery Pkwy Lafayette LA 70508 20 16 1 >=16 1 1 2 30154177 92045831WOMENS MULTI-SPECIALTY GROUP Chesson Ralph MD 4630 Ambassador Caffery Parkway Suite 308 Lafayette LA 70508 20 16 1 none 1 1 2 30153546 92045066WOMENS MULTI-SPECIALTY GROUP Seymour Stephen MD 4630 Ambassador Caffery Parkway Suite 308 Lafayette LA 70508 20 16 1 none 1 1 2 30153546 92045066LAFAYETTE SURGICARE 4630 Ambassador Caffery Pkwy Suite 101 Lafayette LA 70508 54 86 1 none 1 1 1 30153546 92045066THE PHYSICIAN'S ALLIANCE CORP (TPAC) Robinson Darrell 4630 Ambassador Caffrey Ste 214, Bldg A Lafayette LA 70508 20 16 1 >=16 1 2 1 30153546 92045066

Bares George Jude MD 4650 Ambassador Caffery Ste 206 Lafayette LA 70508 20 37 1 <=18 1 2 1 30153126 92044556MICHAEL MELANCON Melancon Michael R. MD 4650 Ambassador Caffery Pkwy Ste 105 Lafayette LA 70508 20 37 1 none 1 2 1 30153126 92044556Children's Multi-Specialty Group, LLC Arceneaux Amy NP 4704 Ambassador Caffery Parkway Lafayette LA 70508 78 08 1 none 1 1 2 30151990 92043180Children's Multi-Specialty Group, LLC Baty Darric MD 4704 Ambassador Caffery Parkway Lafayette LA 70508 20 14 1 none 1 1 2 30151990 92043180Children's Multi-Specialty Group, LLC Bennett James MD 4704 Ambassador Caffery Parkway Lafayette LA 70508 20 20 1 none 1 1 2 30151990 92043180Children's Multi-Specialty Group, LLC Dersam Gabriel MD 4704 Ambassador Caffery Parkway Lafayette LA 70508 20 20 1 none 1 1 2 30151990 92043180Children's Multi-Specialty Group, LLC Falterman Kenneth MD 4704 Ambassador Caffery Parkway Lafayette LA 70508 20 1P 1 none 1 1 2 30151990 92043180Children's Multi-Specialty Group, LLC Flatt John MD 4704 Ambassador Caffery Parkway Lafayette LA 70508 20 13 1 none 1 1 2 30151990 92043180Children's Multi-Specialty Group, LLC Flint Janna MD 4704 Ambassador Caffery Parkway Lafayette LA 70508 20 2E 1 none 1 1 2 30151990 92043180Children's Multi-Specialty Group, LLC Morad Ammar MD 4704 Ambassador Caffery Parkway Lafayette LA 70508 20 2H 1 none 1 1 2 30151990 92043180Children's Multi-Specialty Group, LLC Vlasic Vukmir MD 4704 Ambassador Caffery Parkway Lafayette LA 70508 20 29 1 none 1 1 2 30151990 92043180Children's Multi-Specialty Group, LLC Yosypiv Ihor MD 4704 Ambassador Caffery Parkway Lafayette LA 70508 20 2K 1 none 1 1 2 30151990 92043180THE PHYSICIAN'S ALLIANCE CORP (TPAC) Begnaud Stuart 4809 Ambassador Caffery Pkwy Suite 460 Lafayette LA 70508 35 65 1 none 1 2 2 30149930 92040053THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vanderlick Michael 4809 Ambassador Caffery Pkwy Suite 410 Lafayette LA 70508 20 41 1 >=18 1 2 2 30149930 92040053Richard J Piccione MD Lukasko Erica OD 4906 Ambassador Caffery Ste 701 Lafayette LA 70508 28 88 1 None 1 2 1 30148312 92037781Richard J Piccione MD Piccione Richard J MD 4906 Ambassador Caffery Ste 701 Lafayette LA 70508 20 18 1 None 1 2 1 30148312 92037781LABCORP 4906 AMBASSADOR CAFFERY C-1 LAFAYETTE LA 70508 20 30 1 none 1 1 2 30171267 92021735Heart Center of Acadiana Fazal Syed MD 4906 Ambassador Caffery Pkwy Ste 1400 Lafayette LA 70508 20 06 1 >=15 1 2 2 30148312 92037781ONCOLOGICS INC DeLand M. Maitland MD 5000 Ambassador Caffery Building 4 Lafayette LA 70508 20 2J 1 none 1 2 2 30146972 92035401ONCOLOGICS INC Harwood Andrew R. MD 5000 Ambassador Caffery Building 4 Lafayette LA 70508 20 2J 1 none 1 2 1 30146972 92035401ONCOLOGICS INC Krawczyk Julian J. MD 5000 Ambassador Caffery Building 4 Lafayette LA 70508 20 2J 1 none 1 2 1 30146972 92035401ONCOLOGICS INC Prellop Perri B. MD 5000 Ambassador Caffery Building 4 Lafayette LA 70508 20 2J 1 none 1 2 1 30146972 92035401ONCOLOGICS INC Wilt Stephen R. MD 5000 Ambassador Caffery Building 4 Lafayette LA 70508 20 2J 1 none 1 2 1 30146972 92035401ONCOLOGICS INC Wortham Angela H. MD 5000 Ambassador Caffery Building 4 Lafayette LA 70508 20 2J 1 none 1 2 2 30146972 92035401WOMEN'S IMAGING CENTRE-LAFAYETTE 5000 Ambassador Caffery Pkwy Bldg. 10 Lafayette LA 70508 20 30 1 none 1 1 2 30146972 92035401


LOI Contract STP*

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Age Restricti

onPCP Link

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THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allam Mohamad 5000 Ambassador Caffery Pkwy Suite 4a Lafayette LA 70508 20 33 1 none 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dearman Richard 5000 Ambassador Caffery Pkwy Suite 4a Lafayette LA 70508 20 33 1 none 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Feinberg Edgar 5000 Ambassador Caffery Pkwy Suite 4a Lafayette LA 70508 20 33 1 none 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tedesco, IV Victor 5000 Ambassador Caffery Pkwy Suite 4a Lafayette LA 70508 20 33 1 none 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Baker David 5000 Ambassador Caffrey Pkwy Bldg 1 Lafayette LA 70508 20 06 1 none 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Courville Kevin 5000 Ambassador Caffrey Pkwy Bldg 1 Lafayette LA 70508 20 06 1 none 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Detraz Deirdre 5000 Ambassador Caffrey Pkwy Bldg 1 Lafayette LA 70508 78 79 1 >=18 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dobbs James 5000 Ambassador Caffrey Pkwy Bldg 1 Lafayette LA 70508 20 06 1 none 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mallavarapu Christopher 5000 Ambassador Caffrey Pkwy Bldg 1 Lafayette LA 70508 20 06 1 none 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Prejean Stella 5000 Ambassador Caffrey Pkwy Bldg 1 Lafayette LA 70508 78 79 1 >=18 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rochon Brent 5000 Ambassador Caffrey Pkwy Bldg 1 Lafayette LA 70508 20 06 1 none 1 2 2 30146972 92035401THE PHYSICIAN'S ALLIANCE CORP (TPAC) Valentino Vern 5000 Ambassador Caffrey Pkwy Bldg 1 Lafayette LA 70508 20 06 1 none 1 2 2 30146972 92035401BREAST CENTER OF ACADIANA Mathews Gary 935 Camellia Blvd #100 Lafayette LA 70508 20 30 1 none 1 2 2 30165755 92035148ACADIANA FAMILY MEDICAL CENTER 204 Energy Pkwy Lafayette LA 70508 20 08 1 None 1 2 1 30182023 92009928ACADIANA FAMILY MEDICAL CENTER Williams Micheal MeadowBrook Specialty Hospital 204 Energy Pkwy Lafayette LA 70508 20 08 1 none 1 2 1 30182023 92009928HEALTH MANAGEMENT SERVICES Inc 2014 W. Pinhood Rd. Layfayette LA 70508 40 54 1 none 1 2 2 30186797 92012257PEDIATRIC GROUP OF ACADIANA, LLC Sugeng Budi MD 1049 W. Summers Drive Abbeville LA 70510 20 37 1 <=18 1 2 1 29984595 92144490Heart Center of Acadiana Fazal Syed MD 118 N Hospital Dr Abbeville LA 70510 20 06 1 >=15 1 2 2 29972203 92107139ABBEVILLE PROFESSIONAL SERVICES 118 North Hospital Dr Abbeville LA 70510 20 41 1 >=18 1 2 2 29972203 92107139ABBEVILLE GENERAL HOSPITAL 118 North Hospital Drive Abbeville LA 70510 60 86 1 none 1 2 1 29972203 92107139ABBEVILLE ANESTHESIA 118 North Hospital Drive Abbeville LA 70510 79 94 1 none 1 2 1 29972203 92107139THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lege Duane 1828 Veterans Memorial Drive Abbeville LA 70510 35 65 1 none 1 2 2 29980557 92116121LEGE TRICIA H OD Lege Tricia H. OD 204 N. Saint Charles Abbeville LA 70510 28 88 1 none 1 2 1 29975116 92134092MANUEL MEDICAL CLINIC 2405 Alonzo Dr Abbeville LA 70510 20 37 1 <=18 1 2 1 29974871 92109198MANUEL MEDICAL CLINIC Woodring James S. NP 2405 Alonzo Dr Abbeville LA 70510 78 79 1 >=18 1 2 1 29974871 92109198ABBEVILLE GENERAL HOSPITAL 2419 Alonzo St Abbeville LA 70510 79 94 1 none 1 2 1 29974781 92108603JON D LELEUX MD APMC Leleux Jon D. MD 2621 North Dr Abbeville LA 70510 20 06 1 none 1 2 2 29973667 92105625FALLIS CLAUD B OD Fallis Claud B. OD 2650 Veterns Memorial Dr Abbeville LA 70510 28 88 1 none 1 2 1 29974214 92105112PADMINI GUPTA Gupta Padmini MD, FAAP 323 Odea Abbeville LA 70510 20 37 1 <=18 1 2 1 29976250 92109762IBERIA COMP COMM HLTH CTR INC Baca Francisco 800 Charity Street Abbeville LA 70510 78 08 1 none 1 2 2 29972742 92128444IBERIA COMP COMM HLTH CTR INC Marshall Marilyn 800 Charity Street Abbeville LA 70510 20 08 1 none 1 2 2 29972742 92128444IBERIA COMP COMM HLTH CTR INC Verdeflor Diana 800 Charity Street Abbeville LA 70510 78 08 1 none 1 2 1 29972742 92128444THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bordelon Gary 235 Canal Street Arnaudville LA 70512 35 65 1 none 1 2 2 30397521 91928534THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lagrange Karen 235 Canal Street Arnaudville LA 70512 35 65 1 none 1 2 2 30397521 91928534Baldwin Family Care Migues Stacie NP 100 Live Oak St Baldwin LA 70514 78 87 1 None 1 2 2 29837745 91544513TECHE ACTION CLINIC 18331 Hwy 182 West Baldwin LA 70514 72 9L 1 none 1 2 1 29862798 91572138TECHE ACTION CLINIC Brignac Jeanenne C. 18331 Hwy 182 West Baldwin LA 70514 20 08 1 None 1 2 1 29862798 91572138TECHE ACTION CLINIC Bustillo Mayra S. 18331 Hwy 182 West Baldwin LA 70514 20 37 1 <=18 1 2 2 29862798 91572138TECHE ACTION CLINIC Clay Lori W. 18331 Hwy 182 West Baldwin LA 70514 78 08 1 None 1 2 1 29862798 91572138TECHE ACTION CLINIC Clay Melissa W. 18331 Hwy 182 West Baldwin LA 70514 78 08 1 None 1 2 2 29862798 91572138TECHE ACTION CLINIC Delgado Guillermo E. CRNA 18331 Hwy 182 West Baldwin LA 70514 20 16 1 >=16 1 2 2 29862798 91572138TECHE ACTION CLINIC Eure Elizabeth C. 18331 Hwy 182 West Baldwin LA 70514 78 08 1 None 1 2 2 29862798 91572138TECHE ACTION CLINIC Fabre Jennifer C. 18331 Hwy 182 West Baldwin LA 70514 78 08 1 >=18 1 2 2 29862798 91572138TECHE ACTION CLINIC Gautam Chatshu 18331 Hwy 182 West Baldwin LA 70514 20 08 1 None 1 2 1 29862798 91572138TECHE ACTION CLINIC Gisclair Heather R. 18331 Hwy 182 West Baldwin LA 70514 78 08 1 None 1 2 2 29862798 91572138TECHE ACTION CLINIC Hinds Trenton A. 18331 Hwy 182 West Baldwin LA 70514 20 41 1 >=18 1 2 2 29862798 91572138TECHE ACTION CLINIC Miller Candice M. 18331 Hwy 182 West Baldwin LA 70514 78 08 1 >=18 1 2 1 29862798 91572138TECHE ACTION CLINIC Millet Jennifer R. 18331 Hwy 182 West Baldwin LA 70514 78 08 1 None 1 2 2 29862798 91572138TECHE ACTION CLINIC Molinere Stacey B. 18331 Hwy 182 West Baldwin LA 70514 78 08 1 None 1 2 2 29862798 91572138TECHE ACTION CLINIC Morgan Cara M. 18331 Hwy 182 West Baldwin LA 70514 20 08 1 None 1 2 1 29862798 91572138

MeadowBrook Specialty Hosp.MeadowBrook Specialty Hospital


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Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

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TECHE ACTION CLINIC Walker Patrick D. 18331 Hwy 182 West Baldwin LA 70514 20 41 1 >=16 1 2 1 29862798 91572138TECHE ACTION CLINIC Wiltz Gary M. 18331 Hwy 182 West Baldwin LA 70514 20 41 1 >=18 1 2 2 29862798 91572138ACADIANA FAMILY MEDICAL CENTER Williams Micheal 261 Adolph Lane Branch LA 70516 20 08 1 none 1 2 1 30381347 92262043PEDIATRIC GROUP OF ACADIANA, LLC Abou Turk Chirine A. MD 1442 E. Bridge St., Bldg. C Breaux Bridge LA 70517 20 37 1 <=18 1 2 1 30280717 91889849Joseph M. Kowalski, MD, LLC Kowalski Joseph M. MD 1442 East Bridge St. Breaux Bridge LA 70517 20 06 1 none 1 2 2 30280717 91889849St Martin Hospital St Martin Hospital 210 Champagne Blvd Breaux Bridge LA 70517 60 86 1 None 1 2 2 30282238 91890181NATIONAL SEATING & MOBILITY 1000 B. Albertson Pwy Unit 7&8 Broussard LA 70518 40 54 1 none 1 2 2 30106025 91973507ZETA HOME HEALTH CARE 401 West 2nd Street Broussard LA 70518 40 54 1 none 1 2 2 30150058 91960851CARLOS BRUNO Bruno Carlos A. MD 811 Albertson Parkway Suite A Broussard LA 70518 20 37 1 <=18 1 2 1 30138253 91961240THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kennedy Michael P. 111 Saint Charles St Carencro LA 70520 20 08 1 None 1 2 1 30319242 92049263CARENCRO SCHOOL BASED HEALTH CENTER Burnell Michael MD 204 Bridgeport Ln Carencro LA 70520 20 08 1 none 1 2 2 30312245 92062736THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pavich Michelle 204 East Saint Peter Carencro LA 70520 35 65 1 none 1 2 2 30317555 92047892THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rozas Margaret 204 East Saint Peter Carencro LA 70520 35 65 1 none 1 2 1 30317555 92047892PEDIATRIC GROUP OF ACADIANA, LLC Bapat Kavita MD 4141 N. University Carencro LA 70520 20 37 1 <=18 1 2 2 30303305 92049599THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gauthier Ariadne 105 W Ebey Street Church Point LA 70525 20 41 1 >=18 1 2 2 30402739 92214888THE PHYSICIAN'S ALLIANCE CORP (TPAC) Palispis Gloria R. 106 W Ebey St Church Point LA 70525 20 08 1 None 1 2 2 30402958 92215080THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bourgeois Marjorie 119 S. Main Street Church Point LA 70525 35 65 1 none 1 2 2 30405082 92216871TRINITY MEDICAL SUPPLIES LLC 190 St. Matthew Drive Church Point LA 70525 40 54 1 none 1 2 1 30406848 92207185THE PHYSICIAN'S ALLIANCE CORP (TPAC) Williams Michael 810 S Broadway Church Point LA 70525 20 08 1 None 1 2 1 30394469 92211159ACADIA SAINT LANDRY HOSPITAL 810 South Broadway St Church Point LA 70525 60 86 1 none 1 2 2 30394469 92211159THE PHYSICIAN'S ALLIANCE CORP (TPAC) Felton Michael 814 S Broadway St Church Point LA 70525 20 08 1 None 1 2 1 30394431 92211127FELTON FAMILY CARE Felton Michael A. 814 S. Broadway Church Point LA 70525 20 08 1 none 1 2 1 30394431 92211127THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hargroder Ty 820 S Broadway Street Church Point LA 70525 20 08 1 None 1 2 2 30394374 92211078ACADIANA FAMILY MEDICAL CENTER Williams Micheal 830 S. Broadway Church Point LA 70525 20 08 1 none 1 2 1 30394279 92210997

ACADIANA FAMILY MEDICAL CENTER Williams Micheal Acadia St. Landry Hospital Church Point LA 70525 20 08 1 none 1 2 1 30394469 92211159THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daneshfar Bahman 1108 E 8th St Crowley LA 70526 20 2J 1 none 1 2 1 30221739 92363939ONCOLOGICS, INC. DeLand M. Maitland MD 1108 E. 8th Street Crowley LA 70526 20 2J 1 none 1 2 2 30221739 92363939ONCOLOGICS, INC. Harwood Andrew R. MD 1108 E. 8th Street Crowley LA 70526 20 2J 1 none 1 2 1 30221739 92363939ONCOLOGICS, INC. Krawczyk Julian J. MD 1108 E. 8th Street Crowley LA 70526 20 2J 1 none 1 2 1 30221739 92363939ONCOLOGICS, INC. Prellop Perri B. MD 1108 E. 8th Street Crowley LA 70526 20 2J 1 none 1 2 1 30221739 92363939ONCOLOGICS, INC. Wilt Stephen R. MD 1108 E. 8th Street Crowley LA 70526 20 2J 1 none 1 2 1 30221739 92363939ONCOLOGICS, INC. Wortham Angela H. MD 1108 E. 8th Street Crowley LA 70526 20 2J 1 none 1 2 2 30221739 92363939

American Legion Hospital 1305 Crowley Rayne Hwy Crowley LA 70526 60 86 1 None 1 2 2 30226228 92362701American Legion Hospital Bushnell Sherman J CRNA 1305 Crowley Rayne Hwy Crowley LA 70526 91 05 1 None 1 2 1 30226228 92362701American Legion Hospital Cart James R CRNA 1305 Crowley Rayne Hwy Crowley LA 70526 91 05 1 None 1 2 1 30226228 92362701American Legion Hospital Lafleur Jay CRNA 1305 Crowley Rayne Hwy Crowley LA 70526 91 05 1 None 1 2 1 30226228 92362701American Legion Hospital Lantz Brayson CRNA 1305 Crowley Rayne Hwy Crowley LA 70526 91 05 1 None 1 2 2 30226228 92362701

Melanson Michael F MD 1305 Crowley Rayne Hwy Ste A Crowley LA 70526 20 16 1 >=16 Female 1 2 2 30226228 92362701American Legion Hospital Michael Arshavir MD 1305 Crowley Rayne Hwy Crowley LA 70526 20 05 1 None 1 2 2 30226228 92362701DEQUINCY MEMORIAL HOSPITAL 1305 Crowley-Rayne Road Crowley LA 70526 20 1T 1 none 1 2 1 30226228 92362701BC DelaHoussaye MD DelaHoussaye Benton C MD 1307 Crowley Rayne Hwy Ste A Crowley LA 70526 20 16 1 >=16 Female 1 2 2 30226413 92362699THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walker Nancy 1307 Crowley Rayne Hwy Suite C Crowley LA 70526 20 08 1 None 1 2 2 30226413 92362699BAHMAN SABBAGHIAN, MD Sabbaghian Bahman MD 1307 Crowley Rayne Hwy. Suite D Crowley LA 70526 20 02 1 none 1 2 1 30226413 92362699NINA KEITH HALL, MD PMC Hall Nina K. 1325 Loright Avenue Suite C Crowley LA 70526 20 02 1 none 1 2 2 30207744 92356810JOSEPH ELFERT Elfert, Jr. Joseph Daniel MD 1325 Wright Ave Ste F Crowley LA 70526 20 37 1 <=18 1 2 1 30225670 92364728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sabbaghian Bahman 1325 Wright Ave, Ste C Crowley LA 70526 20 02 1 none 1 2 1 30225670 92364728ACADIANA WOUND CARE AND HYPERBARICS-SANDERS 1325 Wright Ave., Ste. C Crowley LA 70526 20 02 1 none 1 2 2 30225670 92364728ACADIANA WOUND CARE AND HYPERBARICS-SANDERS Sanders Christopher Lee MD 1325 Wright Ave., Ste. C Crowley LA 70526 20 1T 1 none 1 2 2 30225670 92364728

810 S. Broadway

American Legion Hospital


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

BAHMAN SABBAGHIAN, MD Sabbaghian Bahman MD 1325 Wright Avenue Suite C Crowley LA 70526 20 02 1 none 1 2 1 30225670 92364728ACADIANA WOUND CARE AND HYPERBARICS-HALL Hall Nina K. MD 1325 Wright Avenue, Suite C Crowley LA 70526 20 02 1 none 1 2 2 30225670 92364728BARONNE FOOT CENTER Baronne Lon M. 1455 Wright Ave Crowley LA 70526 32 48 1 none 1 2 2 30226835 92364728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Katira Mulraj 1455 Wright Ave Crowley LA 70526 20 41 1 >=18 1 2 2 30226835 92364728BARONNE FOOT CENTER McGee Nolia M. 1455 Wright Ave Crowley LA 70526 32 48 1 none 1 2 2 30226835 92364728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Saini Satinder 1455 Wright Ave Crowley LA 70526 20 41 1 >=18 1 2 1 30226835 92364728BARONNE FOOT CENTER Smith George R. 1455 Wright Ave Crowley LA 70526 32 48 1 none 1 2 1 30226835 92364728HAMILTON CARISSA PDC Hamilton-Toups Carissa DC, CEAS 155 Oddfellows Rd Crowley LA 70526 30 35 1 none 1 2 2 30230363 92380857THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kilgore Karrie V. 345 Oddfellow Road Crowley LA 70526 20 08 1 None 1 2 2 30230464 92375570THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stringfellow Paul 345 Oddfellow Road Crowley LA 70526 20 08 1 None 1 2 2 30230464 92375570JON D LELEUX MD APMC Simpson Stephen R. MD 345 Oddfellows Rd Crowley LA 70526 20 06 1 none 1 2 2 30230464 92375570THE PHYSICIAN'S ALLIANCE CORP (TPAC) Holden Joe 421 N Avenue F Crowley LA 70526 20 08 1 None 1 2 1 30212341 92374048JOHN H WISE OD Wise John H. OD 509 N Ave. G Crowley LA 70526 28 88 1 none 1 2 1 30214178 92372261SWLA CENTER FOR HEALTH SERVICES 613 John F. Kennedy Dr. Crowley LA 70526 72 9L 1 none 1 2 1 30207401 92393410SWLA CENTER FOR HEALTH SERVICES Foster Suzanne P. MD 613 John F. Kennedy Dr. Crowley LA 70526 20 37 1 <=18 1 2 2 30207401 92393410SWLA CENTER FOR HEALTH SERVICES Graser Emily NP 613 John F. Kennedy Dr. Crowley LA 70526 78 08 1 none 1 2 1 30207401 92393410SWLA CENTER FOR HEALTH SERVICES Somner John P. MD 613 John F. Kennedy Dr. Crowley LA 70526 20 08 1 none 1 2 2 30207401 92393410SWLA CENTER FOR HEALTH SERVICES Wascomb Stephen M. MD 613 John F. Kennedy Dr. Crowley LA 70526 20 08 1 none 1 2 2 30207401 92393410CROWLEY WALK IN CLINIC Korab Mazen 621 N. Ave K Crowley LA 70526 20 37 1 <=18 1 2 1 30217922 92369051THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cannon Stephen 719 N Eastern Ave Crowley LA 70526 20 08 1 None 1 2 1 30219684 92367340THE PHYSICIAN'S ALLIANCE CORP (TPAC) Albro Daryl 720 N Avenue K Crowley LA 70526 35 65 1 none 1 2 2 30218917 92369243THE PHYSICIAN'S ALLIANCE CORP (TPAC) Arabie Marilyn 720 N Avenue K Crowley LA 70526 35 65 1 none 1 2 2 30218917 92369243THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campbell Antoinettte 720 N Avenue K Crowley LA 70526 35 65 1 none 1 2 2 30218917 92369243THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daigle Brad 720 N Avenue K Crowley LA 70526 35 65 1 none 1 2 2 30218917 92369243THE PHYSICIAN'S ALLIANCE CORP (TPAC) Elter Douglas 720 N Avenue K Crowley LA 70526 35 65 1 none 1 2 2 30218917 92369243THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meche Sarah 720 N Avenue K Crowley LA 70526 35 65 1 none 1 2 2 30218917 92369243THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meche Scott 720 N Avenue K Crowley LA 70526 37 74 1 none 1 2 2 30218917 92369243THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stewart Anne 720 N Avenue K Crowley LA 70526 37 74 1 none 1 2 2 30218917 92369243THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thibodeaux Chris 720 N Avenue K Crowley LA 70526 35 65 1 none 1 2 2 30218917 92369243THE PHYSICIAN'S ALLIANCE CORP (TPAC) Touchet Kevin 720 N Avenue K Crowley LA 70526 35 65 1 none 1 2 2 30218917 92369243Elton Rural Health Clinic Doucet Nicole NP 907 Main St Elton LA 70532 78 87 1 None 1 2 2 30481195 92693551Elton Rural Health Clinic LeBlanc Larry MD 907 Main St Elton LA 70532 20 08 1 None 1 2 1 30481195 92693551Elton Rural Health Clinic Roy Jena NP 907 Main St Elton LA 70532 78 87 1 None 1 2 2 30481195 92693551Elton Rural Health Clinic Sonnier Michael NP 907 Main St Elton LA 70532 78 87 1 None 1 2 2 30481195 92693551Savoy Family Care Doucet Nicole NP 102 South 2nd St Eunice LA 70535 78 87 1 None 1 2 2 30494732 92416221Savoy Family Care Joseph Alex NP 102 South 2nd St Eunice LA 70535 78 87 1 None 1 2 2 30494732 92416221Savoy Family Care Michael Nicole MD 102 South 2nd St Eunice LA 70535 20 37 1 <=18 1 2 2 30494732 92416221Savoy Family Care Sonnier Michael NP 102 South 2nd St Eunice LA 70535 78 87 1 None 1 2 2 30494732 92416221THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bowie Charles 1221 E Laurel Eunice LA 70535 20 34 1 none 1 2 1 30494675 92401265BAHMAN SABBAGHIAN, MD Sabbaghian Bahman MD 151 Hill Street Suite 2 Eunice LA 70535 20 02 1 none 1 2 1 30486811 92433667THE PHYSICIAN'S ALLIANCE CORP (TPAC) Heinen Jade 151 Leon Ave Eunice LA 70535 20 08 1 None 1 2 2 30495390 92391841THE PHYSICIAN'S ALLIANCE CORP (TPAC) Heinen Brian 151 Leon Street Eunice LA 70535 20 08 1 None 1 2 2 30495390 92391841THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith Jason 200 N 2nd Street Eunice LA 70535 30 35 1 none 1 2 2 30496028 92416214THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ware David B. 281 Moosa Blvd Eunice LA 70535 20 08 1 None 1 2 2 30496416 92405099Drs Fink & Moser, LLC Fruge Sarah Moser MD 301 South Second St Eunice LA 70535 28 88 1 none 1 2 2 30492484 92416498Drs Fink & Moser, LLC Moser Rhond Fink MD 301 South Second St. Eunice LA 70535 28 88 1 none 1 2 1 30492484 92416498THE PHYSICIAN'S ALLIANCE CORP (TPAC) Heinen Monty 3448 Highway 190 Eunice LA 70535 20 16 1 >=16 1 2 1 30494759 92387884HEINEN OBSTETRTICS & GYNECOLOGY Heinen Monty N. 3448 Hwy 190 Eunice LA 70535 20 16 1 >=16 1 2 1 30494759 92387884MILLER JR J D OD Miller, Jr. Jack D. 350 Moosa Blvd Eunice LA 70535 28 88 1 none 1 2 2 30496947 92404784Mercy Regional Medical Center 3501 Highway 190 East Eunice LA 70535 60 86 1 none 1 2 2 30495233 92386851


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PRECISION RADIOLOGY MANAGEMENT 3501 Hwy 190 East Eunice LA 70535 20 30 1 none 1 2 2 30495233 92386851THE PHYSICIAN'S ALLIANCE CORP (TPAC) Miller Randall 351 Moosa Blvd Eunice LA 70535 20 41 1 >=18 1 2 2 30496954 92405103PEDIATRIC CARDIOLOGY ASSOCIATES 3521 Hwy 190 Ste Q Eunice LA 70535 20 1D 1 none 1 2 2 30495260 92386262THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barnes, Jr. Donald W. 3521 Hwy 190 Ste W Eunice LA 70535 20 16 1 >=16 1 2 1 30495260 92386262PEDIATRIC CARDIOLOGY ASSOCIATES Brumund Michael R. MD 3521 Hwy 190 Ste Q Eunice LA 70535 20 1D 1 none 1 2 1 30495260 92386262PEDIATRIC CARDIOLOGY ASSOCIATES Crapanzano Michael S. MD 3521 Hwy 190 Ste Q Eunice LA 70535 20 1D 1 none 1 2 1 30495260 92386262THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hebert Charice 3521 Hwy 190 Suite S Eunice LA 70535 20 37 1 <=18 1 2 1 30495260 92386262THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hebert, II Richard L. 3521 Hwy 190 Ste S Eunice LA 70535 20 04 1 none 1 2 1 30495260 92386262PEDIATRIC CARDIOLOGY ASSOCIATES Hixon Rufus L. MD 3521 Hwy 190 Ste Q Eunice LA 70535 20 1D 1 none 1 2 1 30495260 92386262THE PHYSICIAN'S ALLIANCE CORP (TPAC) Matherne Craig 3521 Hwy 190 Suite P Eunice LA 70535 20 08 1 None 1 2 2 30495260 92386262THE PHYSICIAN'S ALLIANCE CORP (TPAC) Robinson Juliet 3521 Hwy 190 Ste V Eunice LA 70535 20 41 1 >=18 1 2 2 30495260 92386262THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pourciau John 3521 Hwy 190 East Ste U Eunice LA 70535 32 48 1 none 1 2 1 30495260 92386262TODD PULLIN M.D. Pullin Todd H. MD 3521 Hwy 190 East Ste N Eunice LA 70535 20 37 1 <=18 1 2 1 30495260 92386262ACADIAN MEDICAL CENTER 400 Moose Blvd Eunice LA 70535 60 86 1 none 1 2 2 30497577 92404791VICTORY HOME MEDICAL 400 W. Maple Ave. Eunice LA 70535 40 54 1 none 1 2 2 30487684 92418890REHAB XCEL OF EUNICE 441 Moosa Blvd. Eunice LA 70535 35 65 1 none 1 2 2 30498052 92405106REHAB XCEL OF EUNICE Brown Emily 441 Moosa Blvd. Eunice LA 70535 37 74 1 none 1 2 2 30498052 92405106THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cashen Joe 441 Moosa Blvd. Eunice LA 70535 35 65 1 none 1 2 2 30498052 92405106THE PHYSICIAN'S ALLIANCE CORP (TPAC) Driggs Angelle 441 Moosa Blvd. Eunice LA 70535 37 74 1 none 1 2 2 30498052 92405106REHAB XCEL OF EUNICE Driggs Michael 441 Moosa Blvd. Eunice LA 70535 35 65 1 none 1 2 2 30498052 92405106THE PHYSICIAN'S ALLIANCE CORP (TPAC) Driggs Ron 441 Moosa Blvd. Eunice LA 70535 35 65 1 none 1 2 2 30498052 92405106THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leger Jennifer 441 Moosa Blvd. Eunice LA 70535 35 65 1 none 1 2 2 30498052 92405106THE PHYSICIAN'S ALLIANCE CORP (TPAC) Martin Catherine 441 Moosa Blvd. Eunice LA 70535 35 65 1 none 1 2 2 30498052 92405106REHAB XCEL OF EUNICE Miller Lee G. 441 Moosa Blvd. Eunice LA 70535 35 65 1 none 1 2 2 30498052 92405106THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stearns Zebediah 450 Moosa Blvd Ste A Eunice LA 70535 20 08 1 None 1 2 1 30498157 92404787TURK JOE E DC Turk Joseph E. DC 610 West Walnut Ave Eunice LA 70535 30 35 1 none 1 2 1 30494002 92421296BELLARDS HOME MEDICAL SUPPLY 621 W Maple Ave Ste B Eunice LA 70535 40 54 1 none 1 2 1 30487397 92421381THE PHYSICIAN'S ALLIANCE CORP (TPAC) Butler Allen 6521 Hwy 190 Suite S Eunice LA 70535 20 04 1 none 1 2 1 30489328 92414882EUNICE MEDICAL SPECIALTIES 711 E. Laurel Avenue Eunice LA 70535 40 54 1 none 1 2 2 30494696 92407121Franklin Foundation Hospital 1097 Northwest Blvd Franklin LA 70538 60 86 1 None 1 2 2 29798593 91529452Franklin Foundation Hospital Clinics 1097 Northwest Blvd Franklin LA 70538 60 86 1 None 1 2 2 29798593 91529452STIRLING CARL T MD Stirling Carl T. MD, FACS 1097 Northwest Blvd Franklin LA 70538 20 02 1 none 1 2 2 29798593 91529452FFH Family Care Center Tesi Donna J MD 1097 Northwest Blvd Franklin LA 70538 20 02 1 None 1 2 2 29798593 91529452Franklin Women's Health Clinic Accardo Rebecca L MD 1097 Northwest Blvd. Franklin LA 70538 20 16 1 >=16 Female 1 2 2 29798593 91529452THE PHYSICIAN'S ALLIANCE CORP (TPAC) Haley Timothy 1105 Northwest Blvd Franklin LA 70538 20 30 1 none 1 2 2 29798554 91529507TECHE ACTION CLINIC 1115 Weber Street Franklin LA 70538 72 9L 1 none 1 2 1 29798468 91505382TECHE ACTION CLINIC Brignac Jeanenne C. 1115 Weber Street Franklin LA 70538 20 08 1 None 1 2 1 29798468 91505382TECHE ACTION CLINIC Bustillo Mayra S. 1115 Weber Street Franklin LA 70538 20 37 1 <=18 1 2 2 29798468 91505382TECHE ACTION CLINIC Clay Lori W. 1115 Weber Street Franklin LA 70538 78 08 1 None 1 2 1 29798468 91505382TECHE ACTION CLINIC Clay Melissa W. 1115 Weber Street Franklin LA 70538 78 08 1 None 1 2 2 29798468 91505382TECHE ACTION CLINIC Delgado Guillermo E. CRNA 1115 Weber Street Franklin LA 70538 20 16 1 >=16 1 2 2 29798468 91505382TECHE ACTION CLINIC Eure Elizabeth C. 1115 Weber Street Franklin LA 70538 78 08 1 None 1 2 2 29798468 91505382TECHE ACTION CLINIC Fabre Jennifer C. 1115 Weber Street Franklin LA 70538 78 08 1 >=18 1 2 2 29798468 91505382TECHE ACTION CLINIC Gautam Chatshu 1115 Weber Street Franklin LA 70538 20 08 1 None 1 2 1 29798468 91505382TECHE ACTION CLINIC Gisclair Heather R. 1115 Weber Street Franklin LA 70538 78 08 1 None 1 2 2 29798468 91505382TECHE ACTION CLINIC Hinds Trenton A. 1115 Weber Street Franklin LA 70538 20 41 1 >=18 1 2 2 29798468 91505382TECHE ACTION CLINIC Miller Candice M. 1115 Weber Street Franklin LA 70538 78 08 1 >=18 1 2 1 29798468 91505382TECHE ACTION CLINIC Millet Jennifer R. 1115 Weber Street Franklin LA 70538 78 08 1 None 1 2 2 29798468 91505382TECHE ACTION CLINIC Molinere Stacey B. 1115 Weber Street Franklin LA 70538 78 08 1 None 1 2 2 29798468 91505382TECHE ACTION CLINIC Morgan Cara M. 1115 Weber Street Franklin LA 70538 20 08 1 None 1 2 1 29798468 91505382


LOI Contract STP*

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New Patient

Age Restricti

onPCP Link

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Postal Code

TECHE ACTION CLINIC Wiltz Gary M. 1115 Weber Street Franklin LA 70538 20 41 1 >=18 1 2 2 29798468 91505382ST MARY PRIMARY CARE LLC Welch-Spencer Keidra MD 1435 Le la Street Franklin LA 70538 20 08 1 None 1 2 1 29807223 91510507KIDD & ASSOCIATES, LLC Comeaux Keith M. OD 1500 Northwest Blvd Franklin LA 70538 28 88 1 none 1 2 1 29796629 91535225KIDD & ASSOCIATES, LLC Kidd, III Milton B. OD 1500 Northwest Blvd Franklin LA 70538 28 88 1 none 1 2 2 29796629 91535225Acadiana Family Practice Associates Horton Randall E MD 1501 Bethia St Franklin LA 70538 20 08 1 None 2 1 2 29806586 91499225ACADIANA FAMILY PRACTICE ASSOCIATES (PPM) 1501 Bethia Street Franklin LA 70538 20 08 1 None 1 2 1 29806586 91499225ACADIANA FAMILY PRACTICE ASSOCIATES (PPM) Allain Brent W. 1501 Bethia Street Franklin LA 70538 79 94 1 none 1 2 1 29806586 91499225ACADIANA FAMILY PRACTICE ASSOCIATES (PPM) Horton Randell E. 1501 Bethia Street Franklin LA 70538 20 08 1 none 1 2 1 29806586 91499225Franklin Women's Health Clinic Accardo Rebecca L MD 1519 Main St Franklin LA 70538 20 16 1 >=16 Female 1 2 1 29801775 91500743FFH Family Care Center Tesi Donna J MD 1820 Main St Franklin LA 70538 20 02 1 None 1 2 2 29806596 91506889STIRLING CARL T MD Stirling Carl T. MD, FACS 600 Haifleigh St Franklin LA 70538 20 02 1 none 1 2 2 29804844 91497731JESUS CHUA Chua Jesus L. 602 Haifleigh St. Franklin LA 70538 20 08 1 none 1 2 1 29804859 91497745

Gunda Sharad V MD 606 Haifleigh St Franklin LA 70538 20 37 1 <=18 1 2 1 29804889 91497772Louis H McCormick MD McCormick Louis H MD 606 Haifleigh St Franklin LA 70538 20 08 1 None 1 2 1 29804889 91497772SHARAD GUNDA Gunda Sharad MD 606 Haifleigh Street Franklin LA 70538 20 37 1 <=18 1 2 1 29804889 91497772GARDINER CENTER HEALTH CLINIC 710 Fifth Street Gueydan LA 70542 79 94 1 none 1 2 2 30027959 92509397GARDINER CENTER HEALTH CLINIC Klorer Susan G. 710 Fifth Street Gueydan LA 70542 78 08 1 none 1 2 2 30027959 92509397Jeanerette Rural Health Clinic Chambers Henrietta NP 217 Bourg St Jeanerette LA 70544 78 87 1 None 1 2 1 29915147 91665978EYE CLINIC A PROFESSIONAL MEDICAL CORP 1219 Elton Rd Jennings LA 70546 20 18 1 none 1 2 2 30232034 92663562OPTICS UNLIMITED, INC 1219 Elton Rd Jennings LA 70546 28 88 1 none 1 2 2 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP Crawford, Jr. Patrick Mark MD 1219 Elton Rd Jennings LA 70546 20 18 1 none 1 2 2 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP East Steven C. OD 1219 Elton Rd Jennings LA 70546 28 88 1 none 1 2 1 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP Gehrig Melvin M. OD 1219 Elton Rd Jennings LA 70546 28 88 1 none 1 2 1 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP Hankin Jeffrey S. OD 1219 Elton Rd Jennings LA 70546 28 88 1 none 1 2 2 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP Iglinsky William L. MD 1219 Elton Rd Jennings LA 70546 20 18 1 none 1 2 2 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP Lacoste Alan D. MD 1219 Elton Rd Jennings LA 70546 20 18 1 none 1 2 2 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP Lafleur Donavon N. OD 1219 Elton Rd Jennings LA 70546 28 88 1 none 1 2 1 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP Mixon William A. MD 1219 Elton Rd Jennings LA 70546 20 18 1 none 1 2 2 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP Murray, IV Lewis Virgil MD 1219 Elton Rd Jennings LA 70546 20 18 1 none 1 2 2 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP O'Byrne Alvaro J. MD 1219 Elton Rd Jennings LA 70546 20 18 1 none 1 2 2 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP Stewart Larry D. MD 1219 Elton Rd Jennings LA 70546 20 18 1 none 1 2 2 30232034 92663562EYE CLINIC A PROFESSIONAL MEDICAL CORP Yokubaitis Jon A. MD 1219 Elton Rd Jennings LA 70546 20 18 1 none 1 2 2 30232034 92663562THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nguyen Lam D. 1322 Elton Rd Ste E Jennings LA 70546 20 41 1 >=18 1 2 2 30234335 92663253BAHMAN SABBAGHIAN, MD Sabbaghian Bahman MD 1322 Elton Rd. Suite H Jennings LA 70546 20 02 1 none 1 2 1 30234335 92663253LACOMB FAMILY MEDICINE Lacomb Amanda M. MD 1322 Elton Rd., Ste. F Jennings LA 70546 20 08 1 none 1 2 1 30234335 92663253THE PHYSICIAN'S ALLIANCE CORP (TPAC) Albro Daryl 1322 Elton Road Suite I Jennings LA 70546 35 65 1 none 1 2 2 30234335 92663253THE PHYSICIAN'S ALLIANCE CORP (TPAC) Arabie Marilyn 1322 Elton Road Suite I Jennings LA 70546 35 65 1 none 1 2 2 30234335 92663253THE PHYSICIAN'S ALLIANCE CORP (TPAC) Campbell Antoinettte 1322 Elton Road Suite I Jennings LA 70546 35 65 1 none 1 2 2 30234335 92663253THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daigle Brad 1322 Elton Road Suite I Jennings LA 70546 35 65 1 none 1 2 2 30234335 92663253THE PHYSICIAN'S ALLIANCE CORP (TPAC) Elter Douglas 1322 Elton Road Suite I Jennings LA 70546 35 65 1 none 1 2 2 30234335 92663253THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meche Scott 1322 Elton Road Suite I Jennings LA 70546 35 65 1 none 1 2 2 30234335 92663253THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stewart Anne 1322 Elton Road Suite I Jennings LA 70546 35 65 1 none 1 2 2 30234335 92663253THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thibodeaux Christopher 1322 Elton Road Suite I Jennings LA 70546 35 65 1 none 1 2 2 30234335 92663253THE PHYSICIAN'S ALLIANCE CORP (TPAC) Touchet Kevin 1322 Elton Road Suite I Jennings LA 70546 35 65 1 none 1 2 2 30234335 92663253LUIS APELLANIZ Apellaniz Luis Francisco 1329 Elton Rd. Ste. P Jennings LA 70546 20 37 1 <=18 1 2 1 30234369 92663571JENNINGS AMERICAN LEGION HOSPITAL 1634 Elton Road Jennings LA 70546 60 86 1 none 1 2 2 30237260 92663276MARCEAUX MICHAEL D CRNA Marceaux Michael D. CRNA 1634 Elton Road Jennings LA 70546 91 05 1 none 1 2 1 30237260 92663276CARAWAY JR WILLIAM K CRNA Caraway William Kent CRNA 1634 Elton Road Jennings LA 70546 91 05 1 none 1 2 1 30237260 92663276WILLIAM DEAN FONTENOT CRNA Fontenot William Dean CRNA 1634 Elton Road Jennings LA 70546 91 05 1 none 1 2 1 30237260 92663276THE PHYSICIAN'S ALLIANCE CORP (TPAC) Deese Charles 217 W Plaquemine Street Jennings LA 70546 30 35 1 none 1 2 2 30222466 92659504


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Charles J. Deese Deese Charles J. 217 W. Plaquemine St Jennings LA 70546 30 35 1 none 1 2 2 30222466 92659504BARRY TIMOTHY J OD Barry Timothy J. OD 418 N. Main Jennings LA 70546 28 88 1 none 1 2 1 30223754 92657842FONTENOT SHANE B OD Fontenot Shane 422 Kade Dr Ste 1 Jennings LA 70546 28 88 1 none 1 2 2 30237200 92663200SYNERGY HOME CARE-ACADIANA REGION, INC 422 Kade Road Jennings LA 70546 44 75 1 none 1 2 2 30237200 92663200THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hindelang, III Floyd M. 516 Trappey Drive Jennings LA 70546 20 30 1 none 1 2 1 30282747 92584640JOHN H WISE OD Wise John H. OD 116 W. Ninth St. Kaplan LA 70548 28 88 1 none 1 2 1 30005438 92282941

Abrom Kaplan Memorial Hospital 1310 W 7th St Kaplan LA 70548 60 86 1 None 1 2 2 30007519 92296585THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lapidus Robert L. 1310 West Seventh St Kaplan LA 70548 20 30 1 none 1 2 2 30007519 92296585THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leleux Patrick 202 N Jackson Street Kaplan LA 70548 20 41 1 >=18 1 2 1 30001476 92292786HAMILTON CARISSA PDC Hamilton-Toups Carissa DC, CEAS 319 N. Cushing Ave Kaplan LA 70548 30 35 1 none 1 2 2 30000104 92284471Primary Care Clinic of Kaplan Bergeaux Scott J MD 707 N Montgomery Kaplan LA 70548 20 08 1 1-99 1 2 2 30007449 92296188JON D LELEUX MD APMC Simpson Stephen R. MD 707 N Montgomery Ave Kaplan LA 70548 20 06 1 none 1 2 2 30007449 92296188PADMINI GUPTA Gupta Padmini MD, FAAP 801 North Montgomery Ave Kaplan LA 70548 20 37 1 <=18 1 2 1 30008285 92295862THE PHYSICIAN'S ALLIANCE CORP (TPAC) Atchetee Whitney 817 East 1st Street Suite 3 Kaplan LA 70548 35 65 1 none 1 2 2 29995680 92277679THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hebert Alexandra 817 East 1st Street Suite 3 Kaplan LA 70548 35 65 1 none 1 2 2 29995680 92277679THE PHYSICIAN'S ALLIANCE CORP (TPAC) Romero James 411 S Main Street Loreauville LA 70552 20 08 1 None 1 2 1 30051172 91737436JAMES RUSSELL ROMERO, MD, RURAL HEALTH CLINIC Romero James R. MD 411 South Main Street Loreauville LA 70552 79 94 1 none 1 2 1 30051172 91737436MEENA A. BAKARE Bakare Meena A. 1008 6th St. Mamou LA 70554 20 37 1 <=18 1 2 1 30636798 92419438THE PHYSICIAN'S ALLIANCE CORP (TPAC) Murdock, Jr. Gerald E. 1413 7th St Ste A Mamou LA 70554 20 02 1 none 1 2 1 30641304 92418578GREGORY SAVOY Savoy Gregory M. 1508 Cajun Dr. Ste B Mamou LA 70554 20 02 1 none 1 2 1 30642248 92406621REGIONAL MEDICAL RENTAL & SALES 700 Poinciana Avenue Mamou LA 70554 40 54 1 none 1 2 2 30641173 92418259Drs Fink & Moser, LLC Fruge Sarah Moser MD 704 Poinciana Mamou LA 70554 28 88 1 none 1 2 2 30641173 92418225Drs Fink & Moser, LLC Moser Rhond Fink MD 704 Poinciana Mamou LA 70554 28 88 1 none 1 2 1 30641173 92418225Mamou Family Care Doucet Nicole NP 704 Poinciana Ave Ste C Mamou LA 70554 78 87 1 None 1 2 2 30641173 92418225Mamou Family Care LeBlanc Larry MD 704 Poinciana Ave Ste C Mamou LA 70554 20 08 1 None 1 2 2 30641173 92418225Mamou Family Care Roy Jena NP 704 Poinciana Ave Ste C Mamou LA 70554 78 87 1 None 1 2 2 30641173 92418225Mamou Family Care Sonnier Michael NP 704 Poinciana Ave Ste C Mamou LA 70554 78 87 1 None 1 2 2 30641173 92418225SAVOY MEDICAL CENTER 801 Poinciana Ave Mamou LA 70554 60 86 1 none 1 2 2 30640896 92417406Savoy Medical Center Burge Eugene CRNA 801 Poinciana Ave Mamou LA 70554 91 05 1 None 1 2 1 30640896 92417406Savoy Medical Center Cassidy Jacqueline CRNA 801 Poinciana Ave Mamou LA 70554 91 05 1 None 1 2 2 30640896 92417406Savoy Medical Center Dupuis Michael CRNA 801 Poinciana Ave Mamou LA 70554 91 05 1 None 1 2 1 30640896 92417406Savoy Medical Center Joseph Alex MD 801 Poinciana Ave Mamou LA 70554 20 41 1 None 1 2 2 30640896 92417406Savoy Medical Center Lahaye Wayne MD 801 Poinciana Ave Mamou LA 70554 20 65 1 None 1 2 2 30640896 92417406Savoy Medical Center Launey Jacob CRNA 801 Poinciana Ave Mamou LA 70554 91 05 1 None 1 2 2 30640896 92417406Savoy Medical Center Leday Patrick CRNA 801 Poinciana Ave Mamou LA 70554 91 05 1 None 1 2 2 30640896 92417406Savoy Medical Center Shadravan Iraj MD 801 Poinciana Ave Mamou LA 70554 20 41 1 >=18 1 2 2 30640896 92417406THE PHYSICIAN'S ALLIANCE CORP (TPAC) Panelli Victoria 803 Poinciana Ave Mamou LA 70554 20 2H 1 none 1 2 2 30640896 92417389ANDREW J MINARDI JR MD Minardi, Jr. Andrew J. MD 809 Cherry Street Mamou LA 70554 20 02 1 none 1 2 2 30643100 92413200ALEXANDRIA CARDIOLOGY CLINIC Kaimol P. K. 1605 7th Street Momar LA 70554 20 06 1 >=18 1 2 2 30627200 92418300ABBEVILLE GENERAL HOSPITAL 207 Milton Road Maurice LA 70555 79 94 1 none 1 2 1 30102707 92123297IBERIA COMP COMM HLTH CTR INC 806 Jefferson Terrace Iberia LA 70560 72 9L 1 none 1 2 1 29987972 91810120PARISH ANESTHESIA OF LAFAYETTE 2309 E. Main Street Suite 300 Lafayette LA 70560 20 05 1 none 1 2 2 29988685 91784605LABCORP 1102 E ADMIRAL DOYLE DR STE 11 NEW IBERIA LA 70560 20 30 1 none 1 1 2 29984701 91819300LOUISIANA MEDICAL SUPPLY INC 201 East Main Street New Iberia LA 70560 40 54 1 >=18 1 2 2 30004929 91817082The Childrens Practice Cocke Kelli MD 2308 E Main St Ste H New Iberia LA 70560 20 37 1 <=18 1 2 1 29988437 91784741The Childrens Practice DeGravelle Martin MD 2308 E Main St Ste H New Iberia LA 70560 20 37 1 <=18 1 2 2 29988437 91784741The Childrens Practice Golan Tomas MD 2308 E Main St Ste H New Iberia LA 70560 20 37 1 <=18 1 2 2 29988437 91784741Monty J Rizzo MD Rizzo Monty J MD 2308 E Main St Ste B New Iberia LA 70560 20 17 1 None 1 2 2 29988437 91784741The Childrens Practice Scott Walter I MD 2308 E Main St Ste H New Iberia LA 70560 20 37 1 <=18 1 2 2 29988437 91784741

Abrom Kaplan Memorial Hospital


LOI Contract STP*

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Specialty Code

New Patient

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onPCP Link

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The Childrens Practice Thompson Shelly K MD 2308 E Main St Ste H New Iberia LA 70560 20 37 1 <=18 1 2 1 29988437 91784741The Childrens Practice Toups Lori MD 2308 E Main St Ste H New Iberia LA 70560 20 37 1 <=18 1 2 2 29988437 91784741Jason Morvant MD Morvant Jason MD 2309 E Main St Ste 200 New Iberia LA 70560 20 02 1 None 1 2 2 29988685 91784605Kurt Obrien MD Obrien Kurt B MD 2309 E Main St Ste 200 New Iberia LA 70560 20 02 1 None 1 2 2 29988685 91784605THE PHYSICIAN'S ALLIANCE CORP (TPAC) Green Justin 2309 E Main Street Suite 201 New Iberia LA 70560 32 48 1 none 1 2 1 29988685 91784605THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cousin George 2309 East Main Street Suite 400 New Iberia LA 70560 20 08 1 None 1 2 2 29988685 91784605THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hales James D. 2309 East Main Street Suite 202 New Iberia LA 70560 19 29 1 none 1 2 1 29988685 91784605THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mata Jose 2309 East Main Street Suite 400 New Iberia LA 70560 20 08 1 None 1 2 2 29988685 91784605Rheumatology Associates of Iberia Hojaili Bernard MD 2312 E Main St Ste C New Iberia LA 70560 20 2M 1 None 1 2 2 29988430 91784723THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hojaili Bernard S. 2312 E Main Street, Ste C New Iberia LA 70560 20 2M 1 none 1 2 2 29988430 91784723Iberia Family MD, LLC Palmiano Alberto M. MD, FAAFP 2312 E. Main Street Suite B New Iberia LA 70560 20 08 1 None 1 2 1 29988430 91784723Kevin C Dupke MD Dupke Kevin C MD 2313 E Main St Ste C New Iberia LA 70560 20 06 1 None 1 2 2 29988678 91784587Paul Gulotta MD Gulotta Paul H MD 2313 E Main St Ste C New Iberia LA 70560 20 06 1 None 1 2 2 29988678 91784587

Poirier Kelly NP 2313 E Main St Ste C New Iberia LA 70560 78 87 1 None 1 2 2 29988678 91784587LEANDRE W. ODOM, D.O. Odom LeAndre W. 2313 E. Main Street Suite B New Iberia LA 70560 19 08 1 None 1 2 1 29988678 91784587The Childrens Center DeGravelle Martin MD 2315 E Main St New Iberia LA 70560 20 37 1 <=18 1 2 2 29988674 91784578The Childrens Center Golan Tomas MD 2315 E Main St New Iberia LA 70560 20 37 1 <=18 1 2 2 29988674 91784578Iberia Medical Center Iberia Medical Center 2315 E Main St New Iberia LA 70560 60 86 1 None 1 2 2 29988674 91784578Iberia Medical Center Home Health Iberia Medical Center Home Health 2315 E Main St New Iberia LA 70560 44 75 1 None 1 2 2 29988674 91784578Rehab Center of Iberia Medical Ctr Rehab Center of Iberia Medical Ctr 2315 E Main St New Iberia LA 70560 65 65 1 None 1 2 2 29988674 91784578The Childrens Center Scott Walter MD 2315 E Main St New Iberia LA 70560 20 37 1 <=18 1 2 2 29988674 91784578DYNAMIC ORTHOTIC SERVICES, INC Margaglio Sam 410 West Main St. New Iberia LA 70560 40 53 1 none 1 2 2 30010228 91822103THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ritter Therese 516 Jefferson Terrace Blvd Suite 200 New Iberia LA 70560 35 65 1 none 1 2 2 29991169 91805702

Sagrera George D MD 602 W St Peter New Iberia LA 70560 20 08 1 None 1 2 2 29988256 91826305GEORGE SAGRERA Sagrera George Douglas MD 602 W. St. Peter St. New Iberia LA 70560 20 08 1 none 1 2 2 29997984 91826480EVANGELINE OPTICAL DISPENSARY Hoffpauir Tim 611 E. Admiral Doyle New Iberia LA 70560 28 88 1 none 1 2 2 29989834 91829693J STEPHEN RILEY OD Riley J. Stephen OD 611 E. Admiral Doyle Dr. New Iberia LA 70560 28 88 1 none 1 2 2 29989834 91829693SYNERGY HOME CARE-CAPITOL REGION INC 801 S. Lewis Ste 4 New Iberia LA 70560 44 75 1 none 1 2 2 29990330 91814183IBERIA COMP COMM HLTH CTR INC 806 Jefferson Terrace New Iberia LA 70560 72 9L 1 none 1 2 2 29987972 91810120HANGER PROSTHETICS AND ORTHOTICS 1033 Andre St Ste A New Iberia LA 70563 40 53 1 none 1 2 1 30008125 91794590Hanger Prosthetics & Orthotics Inc. 1033 Andre Street Suite A New Iberia LA 70563 40 53 1 none 1 1 2 30008125 91794590HANGER PROSTHETICS AND ORTHOTICS 1033 Andre Street, Suite A New Iberia LA 70563 40 53 1 none 1 2 1 30008125 91794590DAUTERIVE PHYSICIANS LLC Tuten, Jr. Harry "Lane" MD 1100 Andre St. Ste 101 New Iberia LA 70563 20 02 1 none 1 1 2 30007578 91794084THE PHYSICIAN'S ALLIANCE CORP (TPAC) Alvarez Luis E. 1100 Andre Street Suite 301 New Iberia LA 70563 20 10 1 none 1 2 1 30007578 91794084DAUTERIVE PHYSICIANS LLC Dauterive Edward MD 1100 Andre Street Suite 101 New Iberia LA 70563 20 2P 1 none 1 1 2 30007578 91794084Ellen Shea Mullen MD Mullen Ellen Shea MD 2205 Old Jeanerette Rd New Iberia LA 70563 20 08 1 None 1 2 2 29996986 91791051Timothy A Viator MD Viator Timothy A MD 2205 Old Jeanerette Rd New Iberia LA 70563 20 08 1 None 1 2 2 29996986 91791051EVANGELINE OPTICAL DISPENSARY Hoffpauir Tim 306A N. Lewis New Iberia LA 70563 28 88 1 none 1 2 2 30003655 91798201THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith Kimberly 500 N Lewis Ave Ste 110 New Iberia LA 70563 20 41 1 >=18 1 2 2 30006789 91796013DAUTERIVE PHYSICIANS LLC Benson David C. MD 500 N. Lewis St. Ste 270 New Iberia LA 70563 20 34 1 none 1 1 2 30006789 91796013DAUTERIVE PHYSICIANS LLC Rosenzweig Seth MD 500 N. Lewis St. Suite 280 New Iberia LA 70563 20 20 1 none 1 1 2 30006789 91796013ABBEVILLE GEN HOSP/TOTAL WOMENS HEALTH Blue Donald R. MD 520 N. Lewis St Ste 103 New Iberia LA 70563 20 16 1 >=16 1 2 1 30006971 91795899PEDIATRIC GROUP OF ACADIANA, LLC Arunachalam Annapoorani MD 520 N. Lewis St. Suite 202 New Iberia LA 70563 20 37 1 <=18 1 2 1 30006971 91795899PEDIATRIC GROUP OF ACADIANA, LLC Atwi Jibran E. MD 520 N. Lewis St. Suite 202 New Iberia LA 70563 20 37 1 <=18 1 2 1 30006971 91795899PEDIATRIC GROUP OF ACADIANA, LLC Eikel Henry MD 520 N. Lewis St. Suite 202 New Iberia LA 70563 20 37 1 <=18 1 2 1 30006971 91795899PEDIATRIC GROUP OF ACADIANA, LLC Golan Yasmin MD 520 N. Lewis St. Suite 202 New Iberia LA 70563 20 37 1 <=18 1 2 2 30006971 91795899DAUTERIVE PHYSICIANS LLC Boudreaux Stephen MD 520 N. Lewis St. Suite 100 New Iberia LA 70563 20 08 1 none 1 1 2 30006971 91795899DAUTERIVE PHYSICIANS LLC Lahasky Robert MD 520 N. Lewis St. Suite 203 New Iberia LA 70563 20 08 1 none 1 1 2 30006971 91795899DAUTERIVE PHYSICIANS LLC Landry Jason MD 520 N. Lewis St. Suite 101 New Iberia LA 70563 20 08 1 none 1 1 2 30006971 91795899DAUTERIVE PHYSICIANS LLC Nugent Janice N. MD 520 N. Lewis St. Ste 204 New Iberia LA 70563 20 41 1 >=18 1 1 2 30006971 91795899


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

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Postal Code

ONCOLOGICS INC DeLand M. Maitland MD 525 North Lewis Street New Iberia LA 70563 20 2J 1 none 1 2 2 30007134 91796159ONCOLOGICS INC Harwood Andrew R. MD 525 North Lewis Street New Iberia LA 70563 20 2J 1 none 1 2 1 30007134 91796159ONCOLOGICS INC Krawczyk Julian J. MD 525 North Lewis Street New Iberia LA 70563 20 2J 1 none 1 2 1 30007134 91796159ONCOLOGICS INC Prellop Perri B. MD 525 North Lewis Street New Iberia LA 70563 20 2J 1 none 1 2 1 30007134 91796159ONCOLOGICS INC Wilt Stephen R. MD 525 North Lewis Street New Iberia LA 70563 20 2J 1 none 1 2 1 30007134 91796159ONCOLOGICS INC Wortham Angela H. MD 525 North Lewis Street New Iberia LA 70563 20 2J 1 none 1 2 2 30007134 91796159DAUTERIVE HOSPITAL (HCA) 600 N. Lewis Street New Iberia LA 70563 60 86 1 none 1 1 2 30007755 91795358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Landry Thomas 600 Rue De Brille New Iberia LA 70563 35 65 1 none 1 2 2 30007100 91792307THE PHYSICIAN'S ALLIANCE CORP (TPAC) Markowich Kathryn 600 Rue De Brille New Iberia LA 70563 35 65 1 none 1 2 2 30007100 91792307THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meyers Karlyn 600 Rue De Brille New Iberia LA 70563 37 74 1 none 1 2 2 30007100 91792307THE PHYSICIAN'S ALLIANCE CORP (TPAC) Munson Joan 600 Rue De Brille New Iberia LA 70563 35 65 1 none 1 2 2 30007100 91792307THE PHYSICIAN'S ALLIANCE CORP (TPAC) Roy, II Clyde 602 N Lewis Street Suite 400 New Iberia LA 70563 20 34 1 none 1 2 2 30007967 91795208EVANGELINE OPTICAL DISPENSARY Hoffpauir Tim 607 Rue de Brilla New Iberia LA 70563 28 88 1 none 1 2 2 30007351 91792530THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sigue Gerard 609 Rue Debrille New Iberia LA 70563 20 2K 1 none 1 2 2 30011259 91809380JESUS GARCIA MD Garcia Jesus Rene MD 613 Rue De Onetta New Iberia LA 70563 20 08 1 None 1 2 2 30006961 91791429CHILDREN'S KIDMED CLINIC INC 1110 Dr. A.C. Terrance Blvd. Suite 2 Opelousas LA 70570 79 94 1 none 1 2 1 30543600 92075800GREGORY GLOWACKI Glowacki Gregory L. MD 1200 Hospital Dr. Ste 2 Opelousas LA 70570 20 37 1 <=18 1 2 1 30543477 92074881THOMAS G. JONES III, MD Jones, III Thomas G. MD 1200 Hospital Drive Suite 2 Opelousas LA 70570 20 37 1 <=18 1 2 1 30543477 92074881THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chatman Eric 1200 Hospital Drive, Suite 5 Opelousas LA 70570 20 41 1 >=18 1 2 2 30543477 92074881Personal Reflections Ray Sheila D. 1202 Heather Dr. Opelousas LA 70570 40 53 1 none 1 2 2 30508299 92074248Daniel H Buller MD Buller Daniel H MD 1233 Wayne Gilmore Circle Ste 250B Opelousas LA 70570 20 02 1 None 1 2 2 30543600 92075800Kerry T Thibodeaux MD Thibodeaux Kerry T MD 1233 Wayne Gilmore Circle Ste 250B Opelousas LA 70570 20 02 1 None 1 2 1 30543600 92075800Dr Louis A Klerkhoff MD Kerkhoff Louis MD 1268 Attakapas Dr Ste 102 Opelousas LA 70570 20 16 1 >=16 Female 1 2 1 30545218 92076559THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dorta Jose 1270 Attakapas Dr Ste 404 Opelousas LA 70570 20 16 1 >=16 1 2 2 30545231 92076540Women's Ctr for Better Health Jarnagin Thomas R MD 1270 Attakapas Dr Ste 101 Opelousas LA 70570 20 16 1 >=12 Female 1 2 1 30545231 92076540KEMPF JOHN MD Kempf John MD 1270 Attakapas Dr., Ste. 102 Opelousas LA 70570 20 16 1 >=16 1 2 1 30545231 92076540THE PHYSICIAN'S ALLIANCE CORP (TPAC) Faucheux Christina 1270 Attakapas Drive Suite 501 Opelousas LA 70570 35 65 1 none 1 2 2 30545231 92076540THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moreau, III Alvin 1270 Attakapas Drive Suite 501 Opelousas LA 70570 35 65 1 none 1 2 1 30545231 92076540THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moreau, Jr Alvin 1270 Attakapas Drive Suite 501 Opelousas LA 70570 35 65 1 none 1 2 2 30545231 92076540THE PHYSICIAN'S ALLIANCE CORP (TPAC) Duplechain Gregory 138 Lazaro Blvd Opelousas LA 70570 20 04 1 none 1 2 1 30469900 92080270ALLEN MEDICAL SUPPLIES INC 209 North Market St Opelousas LA 70570 40 54 1 none 1 2 2 30535548 92083978CHRISTIAN R V OD Christian R. V. OD 232 N. Union St Opelousas LA 70570 28 88 1 none 1 2 1 30535295 92080468SYNERGY HOME CARE-ACADIANA REGION, INC 2410 Jake Drive Opelousas LA 70570 44 75 1 none 1 2 2 30507628 92074736BARONNE FOOT CENTER Baronne Lon M. 2848 South Union Opelousas LA 70570 32 48 1 none 1 2 2 30502825 92087479BARONNE FOOT CENTER McGee Nolia M. 2848 South Union Opelousas LA 70570 32 48 1 none 1 2 2 30502825 92087479BARONNE FOOT CENTER Smith George R. 2848 South Union Opelousas LA 70570 32 48 1 none 1 2 1 30502825 92087479J BRENT PRATHER MD APMC Prather Jonathan Brent MD 2949 S. Union Street Opelousas LA 70570 20 03 1 none 1 2 2 30500805 92087506THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ellender Lee D. 2967 S Union St Opelousas LA 70570 20 08 1 None 1 2 2 30500538 92087553OPELOUSAS SPEECH & HEARING Guillory Joseph A. MD 318 W. North Street Opelousas LA 70570 34 64 1 none 1 2 2 30535662 92085461THE PHYSICIAN'S ALLIANCE CORP (TPAC) Basile Michael 3921 I-49 S Service Rd Opelousas LA 70570 20 08 1 None 1 2 2 30485570 92075471THE PHYSICIAN'S ALLIANCE CORP (TPAC) Braham Laura R. 3921 I-49 S Service Rd Opelousas LA 70570 20 08 1 None 1 2 2 30485570 92075471THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guillory Kevin 3921 I-49 S Service Rd Opelousas LA 70570 20 08 1 None 1 2 2 30485570 92075471THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kelly Latonya R. 3921 I-49 S Service Rd Opelousas LA 70570 20 08 1 None 1 2 1 30485570 92075471THE PHYSICIAN'S ALLIANCE CORP (TPAC) Montgomery Michael 3921 I-49 S Service Rd Opelousas LA 70570 20 08 1 None 1 2 2 30485570 92075471CARDIOLOGY CENTER OF ACADIANA 3975 I - 49 S. Service Rd Ste 234 Opelousas LA 70570 20 06 1 none 1 2 2 30486625 92075231THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daneshfar Bahman 3975 I 49 So Service Rd Suite 10 Opelousas LA 70570 20 2J 1 none 1 2 1 30486625 92075231THE PHYSICIAN'S ALLIANCE CORP (TPAC) Legros Jimmy 3975 I-49 S Service Rd Ste 234 Opelousas LA 70570 78 79 1 >=18 1 2 2 30486625 92075231THE PHYSICIAN'S ALLIANCE CORP (TPAC) Menuet Robert 3975 I-49 S Service Rd Ste 234 Opelousas LA 70570 20 06 1 none 1 2 1 30486625 92075231CARDIOLOGY CENTER OF ACADIANA Dibbs Michael Ziad 3975 I-49 S. Service Rd. Ste 234 Opelousas LA 70570 20 06 1 none 1 2 1 30486625 92075231JOHN W GUIDRY Guidry John Wayne 3975 I-49 S. Service Rd. Opelousas LA 70570 20 41 1 >=18 1 2 2 30486625 92075231


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Granger Glynn A. 3975 I-49 Service Rd South Ste 105 Opelousas LA 70570 20 02 1 none 1 2 2 30486625 92075231THE PHYSICIAN'S ALLIANCE CORP (TPAC) Alemany-lopez Fernando 3975 I-49 South Service Rd Suite 200 Opelousas LA 70570 20 41 1 >=18 1 2 2 30486625 92075231ONCOLOGICS INC DeLand M. Maitland MD 3975 I-49 South Service Rd. Ste. 106 Opelousas LA 70570 20 2J 1 none 1 2 2 30486625 92075231ONCOLOGICS INC Harwood Andrew R. MD 3975 I-49 South Service Rd. Ste. 106 Opelousas LA 70570 20 2J 1 none 1 2 1 30486625 92075231ONCOLOGICS INC Krawczyk Julian J. MD 3975 I-49 South Service Rd. Ste. 106 Opelousas LA 70570 20 2J 1 none 1 2 1 30486625 92075231ONCOLOGICS INC Prellop Perri B. MD 3975 I-49 South Service Rd. Ste. 106 Opelousas LA 70570 20 2J 1 none 1 2 1 30486625 92075231ONCOLOGICS INC Wilt Stephen R. MD 3975 I-49 South Service Rd. Ste. 106 Opelousas LA 70570 20 2J 1 none 1 2 1 30486625 92075231ONCOLOGICS INC Wortham Angela H. MD 3975 I-49 South Service Rd. Ste. 106 Opelousas LA 70570 20 2J 1 none 1 2 2 30486625 92075231THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lapidus Robert L. 3983 I-49 Service Rd Opelousas LA 70570 20 30 1 none 1 2 2 30486782 92075195Moreau Physical Therapy Bozant Ryan 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chamberlain Jerry 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000THE PHYSICIAN'S ALLIANCE CORP (TPAC) Faucheux Christina 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000Moreau Physical Therapy Giles Robin 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000Moreau Physical Therapy Grunewald Kristopher 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000Moreau Physical Therapy Jones Althea 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000Moreau Physical Therapy LeBlanc Kyle 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000THE PHYSICIAN'S ALLIANCE CORP (TPAC) Martin Jude 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000Moreau Physical Therapy Martin Murphy Jude 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moreau, III Alvin 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 1 30487641 92075000Moreau Physical Therapy Moreau, Jr Al C. 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moreau, Jr Alvin 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000Moreau Physical Therapy Pavy Mary Katherine 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000Moreau Physical Therapy Williams Kara 4027 I-49 South Service Road Opelousas LA 70570 35 65 1 none 1 2 2 30487641 92075000THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bidstrup Richard 4049 I-49 S Service Road Opelousas LA 70570 20 04 1 none 1 2 1 30488071 92074902HANGER PROSTHETICS AND ORTHOTICS 421 South Main St Opelousas LA 70570 40 53 1 none 1 2 1 30530466 92082043HANGER PROSTHETICS AND ORTHOTICS 421 South Main Street Opelousas LA 70570 40 53 1 none 1 2 1 30530466 92082043THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bourgeois George 519 E Prudhomme Street Opelousas LA 70570 20 41 1 >=18 1 2 2 30543664 92076197

Opelousas General Health System 539 E Prudhomme Ln Opelousas LA 70570 60 86 1 None 1 2 1 30543601 92075797THE PHYSICIAN'S ALLIANCE CORP (TPAC) 539 E Prudhomme Street Opelousas LA 70570 20 05 1 none 1 2 2 30543601 92075797THE PHYSICIAN'S ALLIANCE CORP (TPAC) 539 E Prudhomme Street Opelousas LA 70570 20 30 1 none 1 2 2 30543601 92075797STACEY MAYEAUX Mayeaux Stacey W. MD 539 E. Prudhomme St Opelousas LA 70570 20 08 1 none 1 2 1 30543601 92075797Pediatrics Clinic Bertrand Charles C. MD 611 Pruddhomme Ste 5 Opelousas LA 70570 20 37 1 <=18 1 2 1 30543406 92074410THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vazquez Salvador 703 E Prudhomme St Opelousas LA 70570 20 02 1 none 1 2 2 30543249 92072965THE PHYSICIAN'S ALLIANCE CORP (TPAC) Amy Eric 703 E Prudhomme Street Opelousas LA 70570 20 02 1 none 1 2 2 30543249 92072965THE PHYSICIAN'S ALLIANCE CORP (TPAC) Castille Thomas 703 East Prudhomme Opelousas LA 70570 20 02 1 none 1 2 2 30543249 92072965ST LANDRY EMS LLC 815 West Landry Street Opelousas LA 70570 51 59 1 none 1 2 2 30534007 92092038THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sanchez Luris 828 Creswell Lane Opelousas LA 70570 20 08 1 None 1 2 1 30519421 92076449SOUTHWEST LA PRIMARY HEALTH CARE 8762 Hwy 182 Opelousas LA 70570 72 9L 1 none 1 2 2 30567702 92072653SOUTHWEST LA PRIMARY HEALTH CARE Duncan Mary FNP-C 8762 Hwy 182 Opelousas LA 70570 78 08 1 none 1 2 2 30567702 92072653SOUTHWEST LA PRIMARY HEALTH CARE Elliott Leone 8762 Hwy 182 Opelousas LA 70570 20 08 1 none 1 2 1 30567702 92072653SOUTHWEST LA PRIMARY HEALTH CARE Trotter Melvin 8762 Hwy 182 Opelousas LA 70570 32 48 1 none 1 2 1 30567702 92072653THE PHYSICIAN'S ALLIANCE CORP (TPAC) Liu Michael 927 E Prudhomme St Opelousas LA 70570 20 2K 1 none 1 2 2 30542275 92063475THE PHYSICIAN'S ALLIANCE CORP (TPAC) Higginbotham John 927 E Prudhomme Street Opelousas LA 70570 20 2K 1 none 1 2 2 30542275 92063475THE PHYSICIAN'S ALLIANCE CORP (TPAC) Miller Paul 927 E Prudhomme Street Opelousas LA 70570 20 2K 1 none 1 2 2 30542275 92063475Opelousas General Hospital Guidry John Wayne 539 E. Prudhomme St Opelousas LA 70570 20 41 1 >=18 1 2 2 30543601 92075797Moreau Physical Therapy Bozant Ryan 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234Moreau Physical Therapy Chamberlain Jerry 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234Moreau Physical Therapy Faucheux Christina 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234Moreau Physical Therapy Giles Robin 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234

Opelousas General Health System


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Moreau Physical Therapy Grunewald Kristopher 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234Moreau Physical Therapy Jones Althea 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234Moreau Physical Therapy LeBlanc Kyle 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234Moreau Physical Therapy Martin Murphy Jude 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234Moreau Physical Therapy Moreau, III Alvin C. 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 1 30547003 91969234Moreau Physical Therapy Moreau, Jr Al C. 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234Moreau Physical Therapy Pavy Mary Katherine 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234Moreau Physical Therapy Williams Kara 16309 Highway 190 Port Barre LA 70577 35 65 1 none 1 2 2 30547003 91969234FREDDIE FANDAL Fandal Freddie 17695 Hwy 190 Port Barre LA 70577 20 08 1 None 1 2 1 30547400 91918000STACEY MAYEAUX Mayeaux Stacey W. MD 17695 Hwy 190 Port Barre LA 70577 20 08 1 none 1 2 1 30547400 91918000REST ASSURE HOME MEDICAL EQUI 412 South Adams Rayne LA 70578 40 54 1 none 1 2 2 30232763 92268939THE PHYSICIAN'S ALLIANCE CORP (TPAC) Babineaux Lendell 500 W. Branche Rayne LA 70578 35 65 1 none 1 2 2 30227501 92272652THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gautreaux Judd 500 W. Branche Rayne LA 70578 35 65 1 none 1 2 2 30227501 92272652Acadiana Family Medical Curtis D Thomas MD 717 Curtis Dr Rayne LA 70578 20 08 1 None 1 2 2 30242751 92255124Acadiana Family Medical Dawson Mark H MD 717 Curtis Dr Rayne LA 70578 20 08 1 None 1 2 1 30242751 92255124Acadiana Family Medical Duhon Neal J MD 717 Curtis Dr Rayne LA 70578 20 08 1 None 1 2 2 30242751 92255124Heart Center of Acadiana Fazal Syed MD 717 Curtis Dr Rayne LA 70578 20 06 1 >=15 1 2 2 30242751 92255124JOHN H WISE OD Wise John H. OD 9171/2 The Blvd Rayne LA 70578 28 88 1 none 1 2 1 30222903 92265911Primary Care Physicians Durham Debra MD 1027A Martin St Ste A Parks LA 70582 20 41 1 >=18 1 2 2 30212200 91831800DANIEL WILTZ Witz Daniel MD 1117 N. Main St. Ste B St. Martinville LA 70582 20 08 1 None 1 2 2 30132763 91827284PEDIATRIC GROUP OF ACADIANA, LLC Blanco Fermin MD 1119 N. Main Street St. Martinville LA 70582 20 37 1 <=18 1 2 2 30132768 91827283PEDIATRIC GROUP OF ACADIANA, LLC Fogleman Trent MD 1119 N. Main Street St. Martinville LA 70582 20 16 1 none 1 2 1 30132768 91827283IBERIA COMP COMM HLTH CTR INC Hatch Sherri 317 Dernier Street St. Martinville LA 70582 78 08 1 none 1 2 1 30115850 91835748IBERIA COMP COMM HLTH CTR INC McLurkin Danielle 317 Dernier Street St. Martinville LA 70582 20 08 1 none 1 2 1 30115850 91835748THE PHYSICIAN'S ALLIANCE CORP (TPAC) Geoffroy Conway 400 South Main Suite D St. Martinville LA 70582 35 65 1 none 1 2 2 30120217 91830065THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schexnailder Roberta 400 South Main Suite D St. Martinville LA 70582 35 65 1 none 1 2 1 30120217 91830065GEOFFROY LARRY A OD Geoffroy Larry 400 South Main St Ste E St. Martinville LA 70582 28 88 1 none 1 2 2 30120217 91830065CUSTOM HEALTHCARE INC Callahan Mike E. 510 West Saul Suite D Lafayette LA 70583 40 54 1 none 1 2 2 30238600 92063700THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hall Nina 611 St Landry St Lafayette LA 70583 20 02 1 none 1 2 2 30254262 92099097LINCARE INC 120 Amedee Rd Scott LA 70583 40 29 1 none 1 2 1 30240382 92069104LINCARE INC DBA PS HOMECA 120 AMEDEE ROAD SCOTT LA 70583 40 54 1 none 1 1 2 30240382 92069104THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stanton Jason 5455 Cameron Street Suite I Scott LA 70583 30 35 1 none 1 2 2 30232800 92087000ACADIA WALK - IN CLINIC CORPORATION Mouawad Dani MD 6100 Cameron St Scott LA 70583 20 37 1 <=18 1 2 1 30234178 92100840ACADIA WALK - IN CLINIC CORPORATION Saleme Mary C. MD 6100 Cameron Street Scott LA 70583 20 37 1 <=18 1 2 2 30234178 92100840FLEUR - DE - LIS COMMUNITY HEALTH Guillory Georgette NP 376 Main St. Cankton LA 70584 78 08 1 None 1 2 1 30417188 92044412FLEUR - DE - LIS COMMUNITY HEALTH 376 Main Street Cankton LA 70584 78 08 1 None 1 2 2 30417188 92044412FLEUR - DE - LIS COMMUNITY HEALTH Dugal John Charles MD 376 Main Street Cankton LA 70584 79 94 1 none 1 2 1 30417188 92044412FLEUR - DE - LIS COMMUNITY HEALTH Neely Angela 376 Main Street Cankton LA 70584 20 08 1 None 1 2 1 30417188 92044412THE PHYSICIAN'S ALLIANCE CORP (TPAC) Burlet Robert 990 Nepoleon Ave Sunset LA 70584 20 08 1 None 1 2 1 30410131 92060865THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daigle Randy 990 Nepoleon Ave Sunset LA 70584 20 08 1 None 1 2 1 30410131 92060865THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sibille John S. 990 Nepoleon Ave Sunset LA 70584 20 08 1 None 1 2 2 30410131 92060865FONTENOT J S OD Fontenot Joseph S. OD 111 Calcasieu Street Ville Platte LA 70586 28 88 1 none 1 2 2 30690085 92278889

Fontenot Charles E MD 1535 W Main St Ste 207 Ville Platte LA 70586 20 08 1 None 1 2 1 30694521 92294430CHARLES FONTENOT Fontenot Charles E. MD 1535 W. Main St. Ste. 6 Ville Platte LA 70586 20 08 1 None 1 2 1 30694521 92294430SOILEAU HOSEA Jr. OD Soileau, Jr. Hosea J. OD 221 W. Cotton Street Ville Platte LA 70586 28 88 1 none 1 2 1 30686563 92277159THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vidrine Steven 417 E Lincoln Rd Ville Platte LA 70586 20 08 1 None 1 2 2 30694056 92265851ALEX JOSEPH MD Joseph Alex MD 735 W. Main Ville Platte LA 70586 20 16 1 >=16 1 2 1 30693165 92286009Mercy Regional Medical Center 800 East Main Street Ville Platte LA 70586 60 86 1 none 1 2 2 30683821 92263033QUALITY MEDICAL CARE AND SERVICES, LLC 903 Tate Cove Rd Ville Platte LA 70586 40 54 1 none 1 2 1 30692499 92262427THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gillespie Patrick 414 N Main Washington LA 70589 20 08 1 None 1 2 1 30616381 92056734


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kang Young 111 South Adams Street Welsh LA 70591 20 08 1 None 1 2 1 30237641 92821784

Family Health Plaza South of LGMC 2810 Bonin Rd Youngsville LA 70592 20 08 1 None 1 2 2 30141722 92007864Family Health Plaza South of LGMC Khan Farha MD 2810 Bonin Rd Youngsville LA 70592 20 41 1 >=18 1 2 2 30141722 92007864Family Health Plaza South of LGMC Larrison James C MD 2810 Bonin Rd Youngsville LA 70592 20 08 1 None 1 2 2 30141722 92007864Family Health Plaza South of LGMC Larrison Sherlyn B MD 2810 Bonin Rd Youngsville LA 70592 20 08 1 None 1 2 2 30141722 92007864Family Health Plaza South of LGMC Perron Andre K MD 2810 Bonin Rd Youngsville LA 70592 20 08 1 None 1 2 2 30141722 92007864THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mousset Xavier 1605 Foster Lake Charles LA 70601 20 06 1 none 1 2 2 30217041 93226726C. H. Wilkinson Physican Network Mousset Xavier MD 1605 Foster Street Lake Charles LA 70601 20 33 1 none 1 2 2 30217041 93226726C. H. Wilkinson Physican Network Khan Mohammad Y. MD 1611 Foster Street Lake Charles LA 70601 20 2H 1 none 1 2 2 30216992 93226714LAKE CHARLES MEMORIAL HOSPITAL 1701 Oak Park Blvd. Lake Charles LA 70601 60 86 1 none 1 2 1 30203598 93197268THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lamkin Kerry PT 1709 W Prien Lake Road Suite B Lake Charles LA 70601 35 65 1 none 1 2 2 30197591 93247823HANGER PROSTHETICS AND ORTHOTICS 1715 Ethel St Lake Charles LA 70601 40 53 1 none 1 2 1 30216423 93222318HANGER PROSTHETICS AND ORTHOTICS 1715 Ethel Street Lake Charles LA 70601 40 53 1 none 1 2 1 30216423 93222318SYNERGY HOME CARE-ACADIANA REGION, INC 1717 East Prien Lake Road Lake Charles LA 70601 44 75 1 none 1 2 2 30198347 93196159EYE CLINIC A PROFESSIONAL MEDICAL CORP 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 20 18 1 none 1 2 2 30203601 93197088OPTICS UNLIMITED, INC 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 28 88 1 none 1 2 2 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP Crawford, Jr. Patrick Mark MD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 20 18 1 none 1 2 2 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP East Steven C. OD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 28 88 1 none 1 2 1 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP Gehrig Melvin M. OD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 28 88 1 none 1 2 1 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP Hankin Jeffrey S. OD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 28 88 1 none 1 2 2 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP Iglinsky William L. MD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 20 18 1 none 1 2 2 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP Lacoste Alan D. MD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 20 18 1 none 1 2 2 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP Lafleur Donavon N. OD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 28 88 1 none 1 2 1 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP Mixon William A. MD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 20 18 1 none 1 2 2 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP Murray, IV Lewis Virgil MD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 20 18 1 none 1 2 2 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP O'Byrne Alvaro J. MD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 20 18 1 none 1 2 2 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP Stewart Larry D. MD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 20 18 1 none 1 2 2 30203601 93197088EYE CLINIC A PROFESSIONAL MEDICAL CORP Yokubaitis Jon A. MD 1717 Oak Park Blvd Ste 1 Lake Charles LA 70601 20 18 1 none 1 2 2 30203601 93197088C. H. Wilkinson Physican Network Kaough Maureen MD 1722 Westwood Street Lake Charles LA 70601 20 41 1 >=18 1 2 2 30215475 93231275C. H. Wilkinson Physican Network McLemore Charles NP 1722 Westwood Street Lake Charles LA 70601 78 08 1 >=18 1 2 2 30215475 93231275C. H. Wilkinson Physican Network Snider Van MD 1722 Westwood Street Lake Charles LA 70601 20 41 1 >=18 1 2 2 30215475 93231275C. H. Wilkinson Physican Network Conner Phillip MD 1736 W. Prient Lake Road Lake Charles LA 70601 20 08 1 None 1 2 2 30226096 93194468THE MEDICAL LABORATORY OF SOUTHWEST LA Bowling Gregory C. MD, APMC 1910 Oak Park Blvd. Lake Charles LA 70601 20 30 1 none 1 2 2 30203124 93194665THE MEDICAL LABORATORY OF SOUTHWEST LA Sachitano Richare A. MD 1910 Oak Park Blvd. Lake Charles LA 70601 20 22 1 none 1 2 2 30203124 93194665SWLA CENTER FOR HEALTH SERVICES Austin James T. MD 2000 Opelousas St Lake Charles LA 70601 20 16 1 >=16 1 2 1 30242098 93193107SWLA CENTER FOR HEALTH SERVICES 2000 Opelousas St. Lake Charles LA 70601 72 9L 1 none 1 2 1 30242098 93193107SWLA CENTER FOR HEALTH SERVICES Browning Lillian NP 2000 Opelousas Street Lake Charles LA 70601 78 08 1 none 1 2 1 30242098 93193107SWLA CENTER FOR HEALTH SERVICES Colligan John L. MD 2000 Opelousas Street Lake Charles LA 70601 20 16 1 none 1 2 1 30242098 93193107SWLA CENTER FOR HEALTH SERVICES Fontenot Crystal A. NP 2000 Opelousas Street Lake Charles LA 70601 78 08 1 >=18 1 2 1 30242098 93193107SWLA CENTER FOR HEALTH SERVICES Kanesan Krishna Kumari MD 2000 Opelousas Street Lake Charles LA 70601 20 37 1 <=18 1 2 1 30242098 93193107SWLA CENTER FOR HEALTH SERVICES Kordisch Stanley MD 2000 Opelousas Street Lake Charles LA 70601 20 16 1 none 1 2 2 30242098 93193107SWLA CENTER FOR HEALTH SERVICES Richter Guadalupe E. MD 2000 Opelousas Street Lake Charles LA 70601 20 37 1 <=18 1 2 1 30242098 93193107SWLA CENTER FOR HEALTH SERVICES Roman Gerardino Melina A. MD 2000 Opelousas Street Lake Charles LA 70601 20 41 1 none 1 2 2 30242098 93193107SWLA CENTER FOR HEALTH SERVICES Trotter Melvin M. DPM 2000 Opelousas Street Lake Charles LA 70601 32 48 1 none 1 2 1 30242098 93193107SWLA CENTER FOR HEALTH SERVICES Varghese Lesly T. MD 2000 Opelousas Street Lake Charles LA 70601 20 08 1 none 1 2 1 30242098 93193107SWLA CENTER FOR HEALTH SERVICES Vaughn Lisa A. DO 2000 Opelousas Street Lake Charles LA 70601 19 16 1 none 1 2 1 30242098 93193107SWLA CENTER FOR HEALTH SERVICES West Kushatha Y. DO 2000 Opelousas Street Lake Charles LA 70601 19 16 1 none 1 2 2 30242098 93193107HERMANN MEDICAL SUPPLIES III 2020 Moeling Street Lake Charles LA 70601 40 54 1 none 1 2 2 30249453 93192651

Family Health Plaza South of LGMC


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

CALCASIEU SPINAL CARE Duhon David Michael DC 2118 East Prien Lake Road Lake Charles LA 70601 30 35 1 none 1 2 2 30198068 93191063THE PHYSICIAN'S ALLIANCE CORP (TPAC) Duhon David DC 2118 East Prim Lake Road Lake Charles LA 70601 30 35 1 none 1 2 2 30198068 93191063COCO'S SHOE STORE INC 2314 Ryan Street Lake Charles LA 70601 40 53 1 none 1 2 2 30209739 93218799C. H. Wilkinson Physican Network Boyer Sylvia MD 2750 Aster Street Lake Charles LA 70601 20 08 1 None 1 2 2 30205075 93200310C. H. Wilkinson Physican Network Dobbins David MD 2750 Aster Street Lake Charles LA 70601 20 08 1 None 1 2 2 30205075 93200310C. H. Wilkinson Physican Network Hutchinson Carolyn MD 2750 Aster Street Lake Charles LA 70601 20 08 1 None 1 2 2 30205075 93200310C. H. Wilkinson Physican Network Kane Percival MD 2750 Aster Street Lake Charles LA 70601 20 08 1 None 1 2 2 30205075 93200310C. H. Wilkinson Physican Network Seep Michael MD 2750 Aster Street Lake Charles LA 70601 20 08 1 None 1 2 2 30205075 93200310THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gilbert Timothy 2770 3rd Ave Suite 345 Lake Charles LA 70601 20 2E 1 none 1 2 2 30199969 93196165SOUTH CAMERON MEMORIAL HOSPITAL 2837 Ernest St Lake Charles LA 70601 79 94 1 >=18 1 2 2 30203803 93223021S CAMERON MEM HOSP HBP/ PACER HEALTH MGMT 2837 Ernest St. Lake Charles LA 70601 20 41 1 >=18 1 2 2 30203803 93223021ASHLEY MEDICAL 3109 Common St Suite 110 Lake Charles LA 70601 40 54 1 >=18 1 2 2 30200864 93213870LINCARE INC 3113 Ryan St. Ste 5 Lake Charles LA 70601 40 54 1 none 1 2 1 30200066 93218457LINCARE INC 3113 RYAN STREET SUITE 5 LAKE CHARLES LA 70601 40 54 1 none 1 1 2 30200066 93218457RADIOLOGY SPECIALISTS 3114 Lake Street Lake Charles LA 70601 20 30 1 none 1 2 2 30200553 93232533WALSON INC 3221 Common St Lake Charles LA 70601 40 54 1 none 1 2 1 30199414 93213864THE PHYSICIAN'S ALLIANCE CORP (TPAC) Abushamat Abdel-Raouf 333 Dr Michael Debakey Dr Suite 140 Lake Charles LA 70601 20 2K 1 none 1 2 2 30218500 93219900New Haven Family Medicine, INC. Adeosun Anthony 333 Dr. Michael Debakey Drive Ste 120 Lake Charles LA 70601 20 08 1 none 1 2 1 30218500 93219900CARL W ROSS Ross Carl W. MD 410 Louisiana Avenue Lake Charles LA 70601 20 08 1 None 1 2 2 30233969 93205787THE PHYSICIAN'S ALLIANCE CORP (TPAC) Belenchia Johnny M. 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 29 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Byrd Gerald 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 10 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chinn Albert 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 29 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Digiglia John 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fastabend Carl 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 06 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gilbert Timothy 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 2E 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gilmore Richard 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 06 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Goolsby Henry 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 2H 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Green Tyson 501 Dr Michal Debakey Drive Lake Charles LA 70601 32 48 1 none 1 2 1 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hale Steven 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 20 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lebeau Thomas 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lewis Ronald 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 41 1 >=18 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Louviere Eugene 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 04 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morris Jason 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morton Craig 501 Dr Michal Debakey Drive Lake Charles LA 70601 35 65 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nichols Paul Hooper 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 10 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Olivier Maureen 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 07 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Oneal Keane 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Peavy Todd 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Primeaux Arthur 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sanders Richard 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 1 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sherk Mary 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Shimer Richard 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 02 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Springer Steve 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tomek Barbara 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 30 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Varela Raul 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 2M 1 none 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wilder Errol 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Williams Homer 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215396 93227217THE PHYSICIAN'S ALLIANCE CORP (TPAC) Williams Luke 501 Dr Michal Debakey Drive Lake Charles LA 70601 20 29 1 none 1 2 2 30215396 93227217CHRISTUS HEALTH SOUTHWESTERN LA 524 Dr. Michael DeBakey Drive Lake Charles LA 70601 60 86 1 none 1 2 2 30215599 93227579C. H. Wilkinson Physican Network Amari Mohammed MD 524 Dr. Michael DeBakey Drive Lake Charles LA 70601 20 41 1 >=18 1 2 2 30215599 93227579


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

C. H. Wilkinson Physican Network Chandoke Megha MD 524 Dr. Michael DeBakey Drive Lake Charles LA 70601 20 08 1 None 1 2 2 30215599 93227579C. H. Wilkinson Physican Network Keys Amanda NP 524 Dr. Michael DeBakey Drive Lake Charles LA 70601 78 08 1 >=18 1 2 2 30215599 93227579C. H. Wilkinson Physican Network LeFuente Michael MD 524 Dr. Michael DeBakey Drive Lake Charles LA 70601 20 41 1 >=18 1 2 2 30215599 93227579C. H. Wilkinson Physican Network McKinnie Mary Jane NP 524 Dr. Michael DeBakey Drive Lake Charles LA 70601 78 08 1 >=18 1 2 2 30215599 93227579C. H. Wilkinson Physican Network Nguyen Hung Henry MD 524 Dr. Michael DeBakey Drive Lake Charles LA 70601 20 41 1 >=18 1 2 2 30215599 93227579C. H. Wilkinson Physican Network Sweeney Aaron MD 524 Dr. Michael DeBakey Drive Lake Charles LA 70601 20 41 1 >=18 1 2 2 30215599 93227579C. H. Wilkinson Physican Network Zhan Maocheng MD 524 Dr. Michael DeBakey Drive Lake Charles LA 70601 20 41 1 >=18 1 2 2 30215599 93227579FINK GEORGE P Find George P. OD 628 A. East Prien Lake Rd Lake Charles LA 70601 28 88 1 none 1 2 1 30244235 93203861C. H. Wilkinson Physican Network Broussard Y. Yoko MD 711 Dr. Michael DeBakey Drive Suite 4 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30214913 93230889ADRIENNE BREAUX Breaux Adrienne 711 Dr. Micheal DeBakey Dr. Suite 600 Lake Charles LA 70601 20 41 1 >=18 1 2 1 30214913 93230889NEIL CLINIC Roy Anand 760 East Bayou Pines Lake Charles LA 70601 20 41 1 >=18 1 2 2 30209542 93231974

Lebato Alan 1525 Oak Park Blvd. Lake Charles LA 70601 20 08 1 None 1 2 2 30203522 93199582

Barootes Bryan 1526 Oak Park Blvd. Lake Charles LA 70601 20 08 1 None 1 2 1 30203247 93199576

Soileau Earl MD 1527 Oak Park Blvd. Lake Charles LA 70601 20 08 1 None 1 2 1 30203521 93199550

Null Danette MD 1528 Oak Park Blvd. Lake Charles LA 70601 20 08 1 None 1 2 2 30203246 93199544

Pham Tuan 1529 Oak Park Blvd. Lake Charles LA 70601 20 08 1 None 1 2 2 30203520 93199519

Harrell Brian MD 1530 Oak Park Blvd. Lake Charles LA 70601 20 08 1 None 1 2 2 30203245 93199513

Axelrad Thomas MD 1717 Oak Park Blvd. 3rd Floor Lake Charles LA 70601 20 20 1 none 1 2 2 30203601 93197088

Cardet Alfred 1717 Oak Park Blvd. 3rd Floor Lake Charles LA 70601 20 20 1 none 1 2 2 30203601 93197088

Cascio Brett 1717 Oak Park Blvd. 3rd Floor Lake Charles LA 70601 20 20 1 none 1 2 2 30203601 93197088

Cohen Nathan MD 1717 Oak Park Blvd. 3rd Floor Lake Charles LA 70601 20 20 1 none 1 2 2 30203601 93197088

Condos, Jr. William R. MD 1717 Oak Park Blvd. 2nd Floor Lake Charles LA 70601 20 06 1 none 1 2 1 30203601 93197088

Drez David 1717 Oak Park Blvd. 3rd Floor Lake Charles LA 70601 20 20 1 none 1 2 2 30203601 93197088

Hofer Scott 1717 Oak Park Blvd. 3rd Floor Lake Charles LA 70601 20 20 1 none 1 2 2 30203601 93197088

Howe Steven MD 1717 Oak Park Blvd. 2nd Floor Lake Charles LA 70601 20 33 1 none 1 2 2 30203601 93197088

Rubino Gregory J. 1717 Oak Park Blvd. 2nd Floor Lake Charles LA 70601 20 14 1 none 1 2 2 30203601 93197088

Ruiz Fernando MD 1717 Oak Park Blvd. 2nd Floor Lake Charles LA 70601 20 06 1 none 1 2 2 30203601 93197088

Thompson Chris MD 1717 Oak Park Blvd. 2nd Floor Lake Charles LA 70601 20 06 1 none 1 2 2 30203601 93197088

Walker Dennis MD 1717 Oak Park Blvd. 3rd Floor Lake Charles LA 70601 20 20 1 none 1 2 2 30203601 93197088

Weber Lawrence MD 1717 Oak Park Blvd. 3rd Floor Lake Charles LA 70601 20 20 1 none 1 2 2 30203601 93197088

LAKE CHARLES MEMORIAL HOSPITAL SYSTEM MEDICAL GROUP




















LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Winterton John 1717 Oak Park Blvd. 2nd Floor Lake Charles LA 70601 20 06 1 none 1 2 2 30203601 93197088

Young Kevin 1717 Oak Park Blvd. 2nd Floor Lake Charles LA 70601 20 06 1 none 1 2 2 30203601 93197088

Agarwal Kushal 2615 Enterprise Blvd. Suite B Lake Charles LA 70601 20 08 1 None 1 2 1 30206629 93204048

Muguku David 2615 Enterprise Blvd. Suite B Lake Charles LA 70601 20 08 1 None 1 2 2 30206629 93204048

Oler Michael 2615 Enterprise Blvd. Suite B Lake Charles LA 70601 20 08 1 None 1 2 2 30206629 93204048

Bergeron Michael 2770 3rd Avenue 2nd Floor Lake Charles LA 70601 20 2H 1 none 1 2 2 30199969 93196165

Broussard Michael L. 2770 3rd Avenue 2nd Floor Lake Charles LA 70601 20 2H 1 none 1 2 2 30199969 93196165

Broussard Robert C. MD 2770 3rd Avenue Suite 110 Lake Charles LA 70601 20 29 1 none 1 2 2 30199969 93196165

Fontenot Reed MD 2770 3rd Avenue Suite 240 Lake Charles LA 70601 20 34 1 none 1 2 2 30199969 93196165

Fredericks Leroy E. MD 2770 3rd Avenue 2nd Floor Lake Charles LA 70601 20 2H 1 none 1 2 2 30199969 93196165

Gaharan James P. MD 2770 3rd Avenue Suite 250 Lake Charles LA 70601 20 2H 1 none 1 2 2 30199969 93196165

Hebert William G. 2770 3rd Avenue Suite 350 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199969 93196165

Jordan Manley MD 2770 3rd Avenue Suite 110 Lake Charles LA 70601 20 29 1 none 1 2 2 30199969 93196165

Kohler Gary J. MD 2770 3rd Avenue Suite 110 Lake Charles LA 70601 20 29 1 none 1 2 2 30199969 93196165

McBroom Stacy MD 2770 3rd Avenue Suite 240 Lake Charles LA 70601 20 34 1 none 1 2 2 30199969 93196165

Moss Lucien Ken MD 2770 3rd Avenue Suite 120 Lake Charles LA 70601 20 02 1 none 1 2 2 30199969 93196165

Moss William C. MD 2770 3rd Avenue Suite 120 Lake Charles LA 70601 20 02 1 none 1 2 2 30199969 93196165

Strong Thomas C. MD 2770 3rd Avenue Suite 120 Lake Charles LA 70601 20 02 1 none 1 2 2 30199969 93196165

Thompson Ben F. 2770 3rd Avenue Suite 110 Lake Charles LA 70601 20 29 1 none 1 2 2 30199969 93196165

Upshaw John 2770 3rd Avenue Suite 240 Lake Charles LA 70601 20 34 1 none 1 2 2 30199969 93196165

Karam Peter W. 2771 3rd Avenue Suite 350 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199976 93195847

Clements Brian D. 2772 3rd Avenue Suite 350 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199966 93196164

Leyoub Susan B. 2773 3rd Avenue Suite 350 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199973 93195847

Speight O. Lynn 2774 3rd Avenue Suite 350 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199963 93196164

Hebert Edward B. MD 2775 3rd Avenue Suite 350 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199970 93195847



























LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

LaFuria Mark MD 2776 3rd Avenue Suite 350 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199960 93196164

Broussard Craig 2777 3rd Avenue Suite 350 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199967 93195847

Khan Akbar 2778 3rd Avenue Suite 351 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199957 93196164

Becnel Louise 2779 3rd Avenue Suite 352 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199964 93195847

Florian Claudia MD 2780 3rd Avenue Suite 353 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199955 93196164

Lewis, Jr. Ron MD 2781 3rd Avenue Suite 354 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199961 93195847

Comeaux Jarmon MD 2782 3rd Avenue Suite 355 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199952 93196164

Romero Christian MD 2783 3rd Avenue Suite 356 Lake Charles LA 70601 20 41 1 >=18 1 2 2 30199958 93195846

Woodard Charles 2801 1st Avenue Suite C Lake Charles LA 70601 20 06 1 none 1 2 1 30204559 93201351Apria Healthcare, Inc. 1830 Ryan St C, D & E Lale Charles LA 70601 40 54 1 none 1 1 2 30214853 93219280THE PHYSICIAN'S ALLIANCE CORP (TPAC) Noble John 1747 Imperial Blvd Lake Charles LA 70605 20 20 1 none 1 2 2 30174100 93249300THE PHYSICIAN'S ALLIANCE CORP (TPAC) Perry James 1747 Imperial Blvd Lake Charles LA 70605 20 20 1 none 1 2 2 30174100 93249300LAKE CHARLES MEMORIAL HOSPITAL 1900 W. Gauthier Rd. Lake Charles LA 70605 60 86 1 none 1 2 1 30139361 93247693PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Babineaux Julie D. 1920 West Sale Rd Ste F7 Lake Charles LA 70605 20 37 1 <=18 1 2 1 30183673 93252130PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Neidigh Timothy S. 1920 West Sale Rd Ste F7 Lake Charles LA 70605 78 08 1 None 1 2 2 30183673 93252130PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Richert, Jr. Albert W. MD 1920 West Sale Rd Ste F7 Lake Charles LA 70605 20 37 1 <=18 1 2 1 30183673 93252130PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Thomas Jenny MD 1920 West Sale Rd Suite F7 Lake Charles LA 70605 20 37 1 <=18 1 2 1 30183673 93252130PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Richert, Sr. Albert W. MD 1920 West Sale Rd. Suite F7 Lake Charles LA 70605 20 37 1 <=18 1 2 1 30183673 93252130PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Rodgers Alyeia L. MD 1920 West Sale Rd. Ste F7 Lake Charles LA 70605 20 37 1 <=18 1 2 1 30183673 93252130PEDIATRIC CARDIOLOGY OF SWLA Kattash Mudar M. MD 2005 Southwood Dr. Lake Charles LA 70605 20 1D 1 <=18 1 2 1 30178343 93251253PEDIATRIC CARDIOLOGY OF SWLA Gugol Rubee Anne MD 2005 Southwood Drive Lake Charles LA 70605 20 1D 1 <=18 1 2 1 30178343 93251253THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vang Charlotte 212 W Mcneese St Lake Charles LA 70605 32 48 1 none 1 2 1 30176309 93221245A COMPLETE FOOT CENTER, LLC Vang Charlotte DPM 212 W. McNeese St. Lake Charles LA 70605 32 48 1 none 1 2 1 30176309 93221245VIDRINE KIMBERLY A ST Vidrine Kimberly SP 227 Heather St Lake Charles LA 70605 29 71 1 none 1 2 2 30165070 93228022MEDICAL TECHNOLOGIES INC 401 W. College Street Lake Charles LA 70605 40 53 1 none 1 2 2 30196297 93224804PRIMARY REHABILITATION SERVICES INC. 4080 Nelson Rd Ste 400 Lake Charles LA 70605 35 65 1 none 1 2 1 30183690 93249523JENNETTE BERGSTEDT Bergstedt Jennette MD 4150 Nelson Rd, Bldg E Ste 1 Lake Charles LA 70605 20 37 1 <=18 1 2 1 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Blossom Eddye MD 4150 Nelson Rd., Bldg. G Suite 6 Lake Charles LA 70605 20 16 1 >=16 1 2 2 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Degazon Yvette MD 4150 Nelson Rd., Bldg. G Suite 5 Lake Charles LA 70605 20 08 1 None 1 2 2 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Diket Albert MD 4150 Nelson Rd., Bldg. G Suite 6 Lake Charles LA 70605 20 16 1 >=16 1 2 1 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Fletcher Dennis MD 4150 Nelson Rd., Bldg. G Suite 5 Lake Charles LA 70605 20 08 1 None 1 2 2 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Ford Thomas MD 4150 Nelson Rd., Bldg. G Suite 1 Lake Charles LA 70605 20 20 1 none 1 2 2 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Green Hilma Lisa MD 4150 Nelson Rd., Bldg. G Suite 7 Lake Charles LA 70605 20 41 1 >=18 1 2 1 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Jadoon Muhammad MD 4150 Nelson Rd., Bldg. G Suite 2 Lake Charles LA 70605 20 41 1 >=18 1 2 2 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Newman Mark MD 4150 Nelson Rd., Bldg. G Suite 6 Lake Charles LA 70605 20 16 1 >=16 1 2 1 30181934 93249502LAKE AREA PHYSICIAN SVC LLC St. Amant Marshall MD 4150 Nelson Rd., Bldg. G Suite 6 Lake Charles LA 70605 20 16 1 >=16 1 2 1 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Stedman Charles MD 4150 Nelson Rd., Bldg. G Suite 6 Lake Charles LA 70605 20 16 1 >=16 1 2 1 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Veillon, Jr. Edward MD 4150 Nelson Rd., Bldg. G Suite 6 Lake Charles LA 70605 20 16 1 >=16 1 2 1 30181934 93249502LAKE AREA PHYSICIAN SVC LLC Kattash Mudar MD 4200 Nelson Rd. Lake Charles LA 70605 20 1D 1 none 1 2 1 30180587 93249490WOMEN & CHILDRENS HOSPITAL 4200 Nelson Road Lake Charles LA 70605 60 86 1 none 1 2 2 30180587 93249490BARRY CRANFORD, OD Cranford Barry OD 4403 Lake Street Lake Charles LA 70605 28 88 1 none 1 2 2 30178572 93232215











LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

LABCORP 4407 NELSON RD LAKE CHARLES LA 70605 20 30 1 none 1 1 2 30177104 93249039THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rider Shaine DC 4451 Nelson Road Lake Charles LA 70605 30 35 1 none 1 2 2 30176668 93249039LAKE AREA PROSTHETICS & ORTHO 505 West College St Lake Charles LA 70605 40 53 1 none 1 2 2 30196299 93226284THE PHYSICIAN'S ALLIANCE CORP (TPAC) Heinen David 5320 Lake Street Lake Charles LA 70605 20 08 1 None 1 2 2 30162045 93232476THE PHYSICIAN'S ALLIANCE CORP (TPAC) Albro Daryl 646 W. Mcnese Lake Charles LA 70605 35 65 1 none 1 2 2 30176297 93228771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meche Sarah 646 W. Mcnese Lake Charles LA 70605 35 65 1 none 1 2 2 30176297 93228771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meche Scott 646 W. Mcnese Lake Charles LA 70605 37 74 1 none 1 2 2 30176297 93228771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Prince Raymond 646 W. Mcnese Lake Charles LA 70605 35 65 1 none 1 2 2 30176297 93228771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thibodeaux Christopher 646 W. Mcnese Lake Charles LA 70605 35 65 1 none 1 2 2 30176297 93228771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Touchet Kevin 646 W. Mcnese Lake Charles LA 70605 35 65 1 none 1 2 2 30176297 93228771

Forsyth Bradley K. 1890 W. Gauthier Rd. Suite 135 Lake Charles LA 70605 20 16 1 >=16 1 2 1 30139362 93247566

Groves William MD 1890 W. Gauthier Rd. Suite 130 Lake Charles LA 70605 20 16 1 >=16 1 2 1 30139362 93247566

Khan Ameer 1890 W. Gauthier Rd. Suite 155 Lake Charles LA 70605 20 08 1 None 1 2 2 30139362 93247566

McKinney Gisele MD 1890 W. Gauthier Rd. Suite 135 Lake Charles LA 70605 20 16 1 >=16 1 2 1 30139362 93247566

Mouton Gerald W. MD 1890 W. Gauthier Rd. Suite 155 Lake Charles LA 70605 20 08 1 None 1 2 2 30139362 93247566

Scroggs Matthew MD 1890 W. Gauthier Rd. Suite 150 Lake Charles LA 70605 20 16 1 >=16 1 2 1 30139362 93247566ADVANCED MEDICAL EQUIPMENT & SUPPLIES INC 1013 E. Mc Neese St Ste B Lake Charles LA 70607 40 54 1 none 1 2 1 30176296 93205700ZETA HOME HEALTH CARE 4901 Common Street Lake Charles LA 70607 40 54 1 none 1 2 2 30168823 93213756EYE CLINIC A PROFESSIONAL MEDICAL CORP 277 Hwy 171 North Ste 4 Lake Charles LA 70611 20 18 1 none 1 2 2 30319300 93199800OPTICS UNLIMITED, INC 277 Hwy 171 North Ste 4 Lake Charles LA 70611 28 88 1 none 1 2 2 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP Crawford, Jr. Patrick Mark MD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 20 18 1 none 1 2 2 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP East Steven C. OD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 28 88 1 none 1 2 1 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP Gehrig Melvin M. OD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 28 88 1 none 1 2 1 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP Hankin Jeffrey S. OD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 28 88 1 none 1 2 2 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP Iglinsky William L. MD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 20 18 1 none 1 2 2 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP Lacoste Alan D. MD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 20 18 1 none 1 2 2 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP Lafleur Donavon N. OD 277 Hwy 171 North Ste Lake Charles LA 70611 28 88 1 none 1 2 1 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP Mixon William A. MD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 20 18 1 none 1 2 2 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP Murray, IV Lewis Virgil MD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 20 18 1 none 1 2 2 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP O'Byrne Alvaro J. MD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 20 18 1 none 1 2 2 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP Stewart Larry D. MD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 20 18 1 none 1 2 2 30319300 93199800EYE CLINIC A PROFESSIONAL MEDICAL CORP Yokubaitis Jon A. MD 277 Hwy 171 North Ste 4 Lake Charles LA 70611 20 18 1 none 1 2 2 30319300 93199800SOUTH CAMERON MEMORIAL HOSPITAL 5360 W CREOLE HWY Cameron LA 70631 60 86 1 none 1 2 2 29808551 93155821S CAMERON MEM HOSP HBP/ PACER HEALTH MGMT 5360 W. Creole Hwy Cameron LA 70631 20 41 1 >=18 1 2 2 29808551 93155821SOUTH CAMERON MEMORIAL HOSPITAL 5360 West Creole Highway Cameron LA 70631 79 94 1 >=18 1 2 2 29808551 93155821WEST CALCASIEU CAMERON HOSPITAL 6240 Gulf Beach Hwy Cameron LA 70631 79 94 1 none 1 2 2 29762536 93690658WEST CALCASIEU CAMERON HOSPITAL Brewer Ruth NP 6240 Gulf Beach Hwy Cameron LA 70631 78 08 1 none 1 2 2 29762536 93690658WEST CALCASIEU CAMERON HOSPITAL George Jody MD 6240 Gulf Beach Hwy Cameron LA 70631 20 08 1 none 1 2 2 29762536 93690658DEQUINCY MEMORIAL HOSPITAL 110 West Fourth Street DeQuincy LA 70633 20 1T 1 none 1 2 2 30451670 93436952DEQUINCY MEMORIAL HOSPITAL 110 West Fourth Street DeQuincy LA 70633 60 86 1 none 1 2 2 30451670 93436952FATAI ADAMSON Adamson Fatai MD 128 West Fourth Street DeQuincy LA 70633 20 37 1 <=18 1 2 1 30451669 93437037YUE ROBIN L MD Yue Robin L. 109 W. Fourth Street DeRidder LA 70634 20 06 1 none 1 2 1 30843553 93286735THOMAS E. GRIFFIN III, M.D. Griffin, III Thomas E. MD 200 West 5th St DeRidder LA 70634 20 37 1 <=18 1 2 1 30842942 93287759HENRY CARTER Carter Henry S. MD 305 W. 7th St Ste C DeRidder LA 70634 20 41 1 >=18 1 2 2 30840848 93289227








LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

BYRD MEDICAL CLINIC Eleyae Oghale E. 325 W. 8th Street DeRidder LA 70634 32 48 1 none 1 2 1 30839345 93289367BYRD MEDICAL CLINIC Park H. John 325 W. 8th Street DeRidder LA 70634 20 20 1 none 1 2 2 30839345 93289367BYRD MEDICAL CLINIC Taylor Flynn A. 412 S. Pine Street DeRidder LA 70634 20 08 1 None 1 2 1 30843649 93289241HANGER PROSTHETICS AND ORTHOTICS 509 South Pine Street DeRidder LA 70634 40 53 1 none 1 2 1 30842729 93288840MAHESH PANDYA Pandya Mahesh R. MD 603 South Pine St DeRidder LA 70634 20 41 1 >=18 1 2 2 30841795 93288891EYE CLINIC A PROFESSIONAL MEDICAL CORP 801 S. Pine St DeRidder LA 70634 20 18 1 none 1 2 2 30839308 93288895OPTICS UNLIMITED, INC 801 S. Pine St DeRidder LA 70634 28 88 1 none 1 2 2 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP Crawford, Jr. Patrick Mark MD 801 S. Pine St DeRidder LA 70634 20 18 1 none 1 2 2 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP East Steven C. OD 801 S. Pine St DeRidder LA 70634 28 88 1 none 1 2 1 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP Gehrig Melvin M. OD 801 S. Pine St DeRidder LA 70634 28 88 1 none 1 2 1 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP Hankin Jeffrey S. OD 801 S. Pine St DeRidder LA 70634 28 88 1 none 1 2 2 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP Iglinsky William L. MD 801 S. Pine St DeRidder LA 70634 20 18 1 none 1 2 2 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP Lacoste Alan D. MD 801 S. Pine St DeRidder LA 70634 20 18 1 none 1 2 2 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP Lafleur Donavon N. OD 801 S. Pine St DeRidder LA 70634 28 88 1 none 1 2 1 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP Mixon William A. MD 801 S. Pine St DeRidder LA 70634 20 18 1 none 1 2 2 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP Murray, IV Lewis Virgil MD 801 S. Pine St DeRidder LA 70634 20 18 1 none 1 2 2 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP O'Byrne Alvaro J. MD 801 S. Pine St DeRidder LA 70634 20 18 1 none 1 2 2 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP Stewart Larry D. MD 801 S. Pine St DeRidder LA 70634 20 18 1 none 1 2 2 30839308 93288895EYE CLINIC A PROFESSIONAL MEDICAL CORP Yokubaitis Jon A. MD 801 S. Pine St DeRidder LA 70634 20 18 1 none 1 2 2 30839308 93288895FOOT CLINIC OF WEST LOUISIANA 801 Shirley St DeRidder LA 70634 32 48 1 none 1 2 2 30847976 93294657FOOT CLINIC OF WEST LOUISIANA Cortz Jayson G. MD 801 Shirley St DeRidder LA 70634 20 48 1 none 1 2 2 30847976 93294657FOOT CLINIC OF WEST LOUISIANA Harvey Jim B. MD 801 Shirley St. DeRidder LA 70634 20 48 1 none 1 2 1 30847976 93294657MICHAEL PERKINS Perkins Michael W. MD 813 Bon Ami St DeRidder LA 70634 20 37 1 <=18 1 2 1 30838679 93290233WEST CALCASIEU CAMERON HOSPITAL Galley Julie NP 1020 Main St Hackberry LA 70645 78 08 1 none 1 2 2 29992731 93366881WEST CALCASIEU CAMERON HOSPITAL Schlamp Kevin MD 1020 Main St Hackberry LA 70645 20 08 1 none 1 2 2 29992731 93366881WEST CALCASIEU CAMERON HOSPITAL 1020 Main Street Hackberry LA 70645 79 94 1 none 1 2 2 29992731 93366881

Kohatsu Jorge A. MD 203 E. Miller Avenue Suite B Iowa LA 70647 20 08 1 None 1 2 1 30245805 93012193THE PHYSICIAN'S ALLIANCE CORP (TPAC) Albro Daryl 702 E. Miller Street Iowa LA 70647 35 65 1 none 1 2 2 30246155 93002729THE PHYSICIAN'S ALLIANCE CORP (TPAC) Arabie Marilyn 702 E. Miller Street Iowa LA 70647 37 74 1 none 1 2 2 30246155 93002729THE PHYSICIAN'S ALLIANCE CORP (TPAC) Elter Douglas 702 E. Miller Street Iowa LA 70647 35 65 1 none 1 2 2 30246155 93002729THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meche Sarah 702 E. Miller Street Iowa LA 70647 35 65 1 none 1 2 2 30246155 93002729THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meche Scott 702 E. Miller Street Iowa LA 70647 37 74 1 none 1 2 2 30246155 93002729THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stewart Anne 702 E. Miller Street Iowa LA 70647 37 74 1 none 1 2 2 30246155 93002729THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thibodeaux Chris 702 E. Miller Street Iowa LA 70647 35 65 1 none 1 2 2 30246155 93002729THE PHYSICIAN'S ALLIANCE CORP (TPAC) Touchet Kevin 702 E. Miller Street Iowa LA 70647 35 65 1 none 1 2 2 30246155 93002729ALLEN PARISH HOSPITAL 108 6th Avenue Kinder LA 70648 60 86 1 none 1 2 2 30482420 92852832ALLEN PARISH HOSPITAL 108 6th Avenue Kinder LA 70648 79 94 1 none 1 2 1 30482420 92852832ALLEN PARISH HOSPITAL Endris Charla 108 6th Avenue Kinder LA 70648 78 08 1 none 1 2 2 30482420 92852832ALLEN PARISH HOSPITAL Rhodes Rebecca C-FNP 108 6th Avenue Kinder LA 70648 78 08 1 none 1 2 2 30482420 92852832ALLEN PARISH HOSPITAL Ughovwa Edward E. MD 108 6th Avenue Kinder LA 70648 20 41 1 none 1 2 1 30482420 92852832PEGGY ALLEMAND Allemand Peggy MD 208 6th Ave., Ste. 5 Kinder LA 70648 20 08 1 None 1 2 2 30484199 92852811IBERIA COMP COMM HLTH CTR INC Lampman Joni 567 Walker Street Merryville LA 70653 78 08 1 none 1 2 2 30758300 93536200IBERIA COMP COMM HLTH CTR INC McMillan John 567 Walker Street Merryville LA 70653 20 08 1 none 1 2 2 30758300 93536200ALLEN PARISH HOSPITAL Homer Dana C-FNP 616 Court Street Oberlin LA 70655 78 08 1 none 1 2 2 30658358 92768773ALLEN PARISH HOSPITAL Nazim Muhammad Mijad MD 616 Court Street Oberlin LA 70655 20 08 1 none 1 2 1 30658358 92768773BYRD MEDICAL CLINIC Yubaraja Bhattarai 18570 Johnny B. Hall Rosepine LA 70659 20 08 1 None 1 2 2 30920391 93282224EYE CLINIC A PROFESSIONAL MEDICAL CORP 2100 Maplewood Dr Sulphur LA 70663 20 18 1 none 1 2 2 30227658 93353394OPTICS UNLIMITED, INC 2100 Maplewood Dr Sulphur LA 70663 28 88 1 none 1 2 2 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP Crawford, Jr. Patrick Mark MD 2100 Maplewood Dr Sulphur LA 70663 20 18 1 none 1 2 2 30227658 93353394



LOI Contract STP*

Geocoding



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Specialty Code

New Patient

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onPCP Link

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EYE CLINIC A PROFESSIONAL MEDICAL CORP East Steven C. OD 2100 Maplewood Dr Sulphur LA 70663 28 88 1 none 1 2 1 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP Gehrig Melvin M. OD 2100 Maplewood Dr Sulphur LA 70663 28 88 1 none 1 2 1 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP Hankin Jeffrey S. OD 2100 Maplewood Dr Sulphur LA 70663 28 88 1 none 1 2 2 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP Iglinsky William L. MD 2100 Maplewood Dr Sulphur LA 70663 20 18 1 none 1 2 2 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP Lacoste Alan D. MD 2100 Maplewood Dr Sulphur LA 70663 20 18 1 none 1 2 2 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP Lafleur Donavon N. OD 2100 Maplewood Dr Sulphur LA 70663 28 88 1 none 1 2 1 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP Mixon William A. MD 2100 Maplewood Dr Sulphur LA 70663 20 18 1 none 1 2 2 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP Murray, IV Lewis Virgil MD 2100 Maplewood Dr Sulphur LA 70663 20 18 1 none 1 2 2 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP O'Byrne Alvaro J. MD 2100 Maplewood Dr Sulphur LA 70663 20 18 1 none 1 2 2 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP Stewart Larry D. MD 2100 Maplewood Dr Sulphur LA 70663 20 18 1 none 1 2 2 30227658 93353394EYE CLINIC A PROFESSIONAL MEDICAL CORP Yokubaitis Jon A. MD 2100 Maplewood Dr Sulphur LA 70663 20 18 1 none 1 2 2 30227658 93353394SULPHUR OPTICAL SHOPPE 4024 Maplewood Dr Sulphur LA 70663 40 54 1 none 1 2 2 30227776 93327658PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Babineaux Julie D. 600 Cypress St Sulphur LA 70663 20 37 1 <=18 1 2 1 30231239 93370518PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Neidigh Timothy S. 600 Cypress St Sulphur LA 70663 78 08 1 None 1 2 2 30231239 93370518PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Richert, Jr. Albert W. MD 600 Cypress St Sulphur LA 70663 20 37 1 <=18 1 2 1 30231239 93370518PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Richert, Sr. Albert W. MD 600 Cypress St Sulphur LA 70663 20 37 1 <=18 1 2 1 30231239 93370518PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Thomas Jenny MD 600 Cypress St Sulphur LA 70663 20 37 1 <=18 1 2 1 30231239 93370518PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Rodgers Alyeia L. MD 600 Cypress St. Sulphur LA 70663 20 37 1 <=18 1 2 1 30231239 93370518PEDIATRIC CENTER OF SOUTHWEST LOUISIANA Vincent Debra S. 600 Cypress Street Sulphur LA 70663 93 37 1 <=18 1 2 1 30231239 93370518WEST CALCASIEU CAMERON HOSPITAL 701 Cypress St Sulphur LA 70663 60 86 1 none 1 2 2 30230920 93368554THE PHYSICIAN'S ALLIANCE CORP (TPAC) Qualls David 702 First Avenue Sulphur LA 70663 35 65 1 none 1 2 2 30231211 93368566SULPHUR SURGICAL CLINIC Castleberry Stephen B. MD 914 Cypress St. Sulphur LA 70663 20 02 1 none 1 2 2 30231172 93365742SULPHUR SURGICAL CLINIC Ledet, Jr. Walter P. MD 914 Cypress St. Sulphur LA 70663 20 02 1 none 1 2 1 30231172 93365742SULPHUR SURGICAL CLINIC O'Donnell Joseph J. MD 914 Cypress St. Sulphur LA 70663 20 02 1 none 1 2 2 30231172 93365742SULPHUR SURGICAL CLINIC Seale A. Kent MD 914 Cypress St. Sulphur LA 70663 20 02 1 none 1 2 2 30231172 93365742THE MAGNOLIA CLINIC INC Boudreaux Marcus NP 914 S. Post Oak Rd Sulphur LA 70663 78 79 1 >=18 1 2 1 30223667 93350676THE MAGNOLIA CLINIC INC Duhon Susan APRN 914 S. Post Oak Rd Sulphur LA 70663 78 79 1 >=18 1 2 1 30223667 93350676CALCASIEU SPINAL CARE Duhon David Michael DC 1801 Maplewood Drive Suphur LA 70663 30 35 1 none 1 2 2 30227279 93357685WEST CALCASIEU CAMERON HOSPITAL 1611 Hampton St Vinton LA 70668 79 94 1 none 1 2 2 30192809 93581768WEST CALCASIEU CAMERON HOSPITAL Waldmeier Lance NP 1611 Hampton St Vinton LA 70668 78 08 1 none 1 2 2 30192809 93581768CUSTOM HEALTHCARE INC Callahan Mike E. 3897 B Hwy. 90 Westlake LA 70669 40 54 1 none 1 2 2 30236956 93298099THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walker Durwin 34870 La Highway 1019 Denham Spgs LA 70706 20 08 1 None 1 2 1 30573753 90957268THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brunson Audrey 35055 La Hwy 16 Suite 1-c Denham Springs LA 70706 35 65 1 none 1 2 2 30572963 90956023THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson Ellis 35055 La Hwy 16 Suite 1-c Denham Springs LA 70706 35 65 1 none 1 2 2 30572963 90956023HANGER PROSTHETICS AND ORTHOTICS 7459 Highway 1 South Addis LA 70710 40 53 1 none 1 2 1 30361784 91261257THE PHYSICIAN'S ALLIANCE CORP (TPAC) Callihan Sheralyn 7523 Highway 1 South Addis LA 70710 35 65 1 none 1 2 2 30360883 91261166Hanger Prosthetics & Orthotics Inc. 7549 Highway 1 South Addis LA 70710 40 53 1 none 1 1 2 30360719 91261144Albany Health Care Clinic Bailey Nicole A APRN 19115 Florida Blvd Ste A Albany LA 70711 78 87 1 >=12 2 1 2 30504707 90593237Baker Eye Clinic Baker Cynthia W OD 12880 Plank Rd Baker LA 70714 28 88 1 None 2 1 2 30564434 91131303Baker Eye Clinic Patin Robert Lucas OD 12880 Plank Rd Baker LA 70714 28 88 1 None 1 2 2 30564434 91131303ERNEST G THOMPSON MD Thompson Ernest Gene MD 12902 Plank Rd Baker LA 70714 20 41 1 >=18 1 2 2 30564748 91131204MARK MOUTON Mouton Mark C. MD 12902 Plank Road Baker LA 70714 20 41 1 >=18 1 2 1 30564748 91131204Major Eye Clinic Major Yvonne OD 13930 Plank Rd Baker LA 70714 28 88 1 none 1 2 1 30574436 91128187Belanger Eye Care Belanger Chad OD 14507 Plank Rd Baker LA 70714 28 88 1 None 2 1 2 30577975 91127564BAKER MEDICAL CORP LTD Manalac Rodolfo M. MD 3034 Ray Weiland Dr Baker LA 70714 20 08 1 None 1 2 2 30586004 91168861MICHAEL A. DEJOHN, MD DeJohn Michael A. MD 4444 GROOM RD Baker LA 70714 20 41 1 >=18 1 2 1 30587213 91153124THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sefa Akwasi 4686 Groom Rd Baker LA 70714 20 41 1 >=18 1 2 1 30586758 91150140THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcculloch Craig 4971 Groom Road Baker LA 70714 35 65 1 none 1 2 2 30586926 91147206THE PHYSICIAN'S ALLIANCE CORP (TPAC) Waldhelm Andy 4971 Groom Road Baker LA 70714 35 65 1 none 1 2 2 30586926 91147206THE PHYSICIAN'S ALLIANCE CORP (TPAC) Folse T'lane 6516 E Myrtle Ave Baker LA 70714 20 41 1 >=18 1 2 1 30578354 91129644


LOI Contract STP*

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New Patient

Age Restricti

onPCP Link

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THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rhodes Kent M. 6516 E Myrtle Ave Baker LA 70714 20 41 1 >=18 1 2 1 30578354 91129644THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith Bradford 6516 E Myrtle Ave Baker LA 70714 20 41 1 >=18 1 2 1 30578354 91129644THE PHYSICIAN'S ALLIANCE CORP (TPAC) Speeg Stephen W. 6516 E Myrtle Ave Baker LA 70714 20 41 1 >=18 1 2 1 30578354 91129644THE PHYSICIAN'S ALLIANCE CORP (TPAC) Giarrusso Brad 6516 East Myrtle Dr Baker LA 70714 20 41 1 >=18 1 2 1 30578354 91129644Westside Family Medicine Higgins Brian P MD 402 N Vaughn St Brusly LA 70719 20 08 1 None 2 1 1 30392473 91240026Westside Family Medicine Munson-Whetstone Vicki Z MD 402 N Vaughn St Brusly LA 70719 20 08 1 None 2 1 2 30392473 91240026RKM PRIMARY CARE Cockerham Yolanda APRN 10410 Plank Road Clinton LA 70722 78 08 1 none 1 2 1 30858709 91011530RKM PRIMARY CARE Holland Amy CPNP 10701 Reiley Street Clinton LA 70722 78 08 1 none 1 2 2 30858844 91022470THE PHYSICIAN'S ALLIANCE CORP (TPAC) DeJohn Michael 11315 Liberty St Clinton LA 70722 20 08 1 None 1 2 1 30866054 91017671RATHBONE CLINIC 11323 Church St Clinton LA 70722 78 08 1 None 1 2 1 30865071 91016824RATHBONE CLINIC Rathbone Richard F. MD 11323 Church St Clinton LA 70722 20 08 1 none 1 2 1 30865071 91016824RKM PRIMARY CARE 11990 Jackson Street Clinton LA 70722 72 9L 1 none 1 2 2 30863862 91022831RKM PRIMARY CARE Attuso Marie Monique MD 11990 Jackson Street Clinton LA 70722 20 08 1 none 1 2 2 30863862 91022831RKM PRIMARY CARE Baker Judy FNP-C 11990 Jackson Street Clinton LA 70722 78 08 1 none 1 2 2 30863862 91022831RKM PRIMARY CARE Blackmon Bettie FNP-C 11990 Jackson Street Clinton LA 70722 78 08 1 none 1 2 2 30863862 91022831RKM PRIMARY CARE Dart, Jr. William D. FNP-C 11990 Jackson Street Clinton LA 70722 78 08 1 none 1 2 1 30863862 91022831RKM PRIMARY CARE Fin Scott J. MD 11990 Jackson Street Clinton LA 70722 20 08 1 none 1 2 2 30863862 91022831RKM PRIMARY CARE Gilliam Darie FNP-C 11990 Jackson Street Clinton LA 70722 78 08 1 none 1 2 1 30863862 91022831RKM PRIMARY CARE Guillot Mary Lou FNP-C 11990 Jackson Street Clinton LA 70722 78 08 1 none 1 2 2 30863862 91022831RKM PRIMARY CARE Hunt Ginger A. FNP-C 11990 Jackson Street Clinton LA 70722 78 08 1 none 1 2 2 30863862 91022831RKM PRIMARY CARE Randall Zelma C. FNP-C 11990 Jackson Street Clinton LA 70722 78 08 1 None 1 2 1 30863862 91022831RKM PRIMARY CARE Toomey Shannon C. OD 11990 Jackson Street Clinton LA 70722 28 88 1 none 1 2 2 30863862 91022831THE PHYSICIAN'S ALLIANCE CORP (TPAC) Damico Brit 9609 Plank Rd Ste P Clinton LA 70722 35 65 1 none 1 2 2 30852466 91007203THE PHYSICIAN'S ALLIANCE CORP (TPAC) Damico Francine M. 9609 Plank Road Ste P Clinton LA 70722 35 65 1 none 1 2 2 30852466 91007203THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kemp Ted 315 Veterans Blvd Denham Spgs LA 70726 20 41 1 >=18 1 2 2 30469972 90964527THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walker Edwin 8369 Florida Blvd Ste 8 Denham Spgs LA 70726 20 08 1 None 1 2 1 30483989 90934076THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walker Patrick 8369 Florida Blvd Ste 8 Denham Spgs LA 70726 20 08 1 None 1 2 1 30483989 90934076AUDIBEL HEARING HEALTHCARE 1111 S. Range Ave. Denham Springs LA 70726 34 64 1 none 1 2 2 30480200 90955800BRIAN ZGANJAR Zganjar Brian E. MD 1211 N. Range Ave Ste D Denham Springs LA 70726 20 37 1 <=18 1 2 1 30499521 90956119CYNTHIA W BAKER, OD Baker Cynthia OD 1330 S. Range Ave. Denham Springs LA 70726 28 88 1 none 1 2 1 30469312 90956391Allergy and Asthma Clinic Yalamanchili Jayaprakash MD 155 Del Orleans Ave Denham Springs LA 70726 20 03 1 None 2 1 1 30469783 90954994Allergy and Asthma Clinic Yalamanchili Jayaprakash MD 155 Del Orleans Ave Denham Springs LA 70726 20 37 1 <=18 2 1 1 30469783 90954994RIPPEL CHIROPRACTIC CLINIC Rippel Jeffrey J. 1680 Benton Lane Denham Springs LA 70726 30 35 1 >=18 1 2 2 30470212 90966127The Eye Center of Denham Springs Wax Brandon OD 206 Petes Hwy Denham Springs LA 70726 28 88 1 None 2 1 2 30483138 90943704BOND EYE CLINIC INC Bessent Richard O. MD 222 Veterans Blvd Denham Springs LA 70726 20 18 1 none 1 2 2 30466668 90960260BOND EYE CLINIC INC Bond R. Hunter OD 222 Veterans Blvd Denham Springs LA 70726 28 88 1 none 1 2 1 30466668 90960260BOND EYE CLINIC INC Nelson Scott K. MD 222 Veterans Blvd Denham Springs LA 70726 20 18 1 none 1 2 2 30466668 90960260BOND EYE CLINIC INC Noguchi Barbara A. MD 222 Veterans Blvd Denham Springs LA 70726 20 18 1 none 1 2 2 30466668 90960260BOND EYE CLINIC INC Paddock Adam OD 222 Veterans Blvd Denham Springs LA 70726 28 88 1 none 1 2 1 30466668 90960260BOND EYE CLINIC INC Pradillo Alan OD 222 Veterans Blvd Denham Springs LA 70726 28 88 1 none 1 2 1 30466668 90960260BOND EYE CLINIC INC Richardson Daphne L. OD 222 Veterans Blvd Denham Springs LA 70726 28 88 1 none 1 2 1 30466668 90960260BOND EYE CLINIC INC Wroten Christopher W. OD 222 Veterans Blvd Denham Springs LA 70726 28 88 1 none 1 2 1 30466668 90960260BOND EYE CLINIC INC Wroten Sarah F. OD 222 Veterans Blvd Denham Springs LA 70726 28 88 1 none 1 2 2 30466668 90960260JANNAIAH TRIPURANENI Tripuraneni Jannaiah 230 Veterans Blvd Ste A Denham Springs LA 70726 20 41 1 >=18 1 2 1 30467108 90961981THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tripuraneni Jannaiah 230 Veterans Boulevard Ste A Denham Springs LA 70726 20 41 1 >=18 1 2 1 30467108 90961981MAGNOLIA RESPIRATORY & MEDICAL 235 Florida Ave SE Denham Springs LA 70726 40 54 1 none 1 2 2 30482864 90954687M Badi Asbahi MD Asbahi M Badi MD 303 Veterans Ste C Denham Springs LA 70726 20 37 1 <=18 2 1 1 30469037 90963404ASBAHI M B MD Asbahi M. Badi MD 303 Veterans Blvd Suite C Denham Springs LA 70726 20 37 1 <=18 1 2 1 30469037 90963404Ochsner Clinic Findley Hillary 30819 LA Highway 16 Denham Springs LA 70726 78 08 1 None 1 2 1 30509715 90956483Ochsner Clinic Harris Amanda 30819 LA Highway 16 Denham Springs LA 70726 78 08 1 None 1 2 2 30509715 90956483


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Collier, Jr. William E. 30819 LA Hwy. 16 Denham Springs LA 70726 20 08 1 None 1 2 2 30509715 90956483Ochsner Clinic Dale Robin B. 30819 LA Hwy. 16 Denham Springs LA 70726 20 08 1 None 1 2 2 30509715 90956483Ochsner Clinic Germany Robyn B. 30819 LA Hwy. 16 Denham Springs LA 70726 20 08 1 None 1 2 2 30509715 90956483Ochsner Clinic Qureshi Arif 30819 LA Hwy. 16 Denham Springs LA 70726 20 08 1 None 1 2 2 30509715 90956483THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ponsock Alicia 311 Veterans Blvd Suite A Denham Springs LA 70726 35 65 1 none 1 2 2 30469949 90964491THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 31925 La Hwy 16 Denham Springs LA 70726 20 03 1 none 1 2 2 30530231 90956326THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 31925 La Hwy 16 Denham Springs LA 70726 20 08 1 none 1 2 2 30530231 90956326THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 31925 La Hwy 16 Denham Springs LA 70726 20 41 1 >=18 1 2 2 30530231 90956326THE PHYSICIAN'S ALLIANCE CORP (TPAC) Basso Brandi 31995 Hwy 16 Denham Springs LA 70726 20 41 1 >=18 1 2 2 30531318 90956322THE PHYSICIAN'S ALLIANCE CORP (TPAC) Folgar Rosa Desha 31995 Hwy 16 Denham Springs LA 70726 20 41 1 >=18 1 2 2 30531318 90956322JOSEPH A YALE DDS 348 VETERANS BOULEVARD DENHAM SPRINGS LA 70726 32 48 1 none 1 1 2 30469820 90965115ASSOCIATES IN PEDIATRIC DENTISTRY 419 SOUTH RANGE AVENUE SUITE A DENHAM SPRINGS LA 70726 32 48 1 none 1 1 2 30480961 90956123THE PHYSICIAN'S ALLIANCE CORP (TPAC) Arlos Roche 8128 Florida Blvd Denham Springs LA 70726 37 74 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ballay Kelly 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bordage Daniel 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bowers Alyce 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cashio Claire 8128 Florida Blvd Denham Springs LA 70726 29 71 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chesnut Crista 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cimo Christy 8128 Florida Blvd Denham Springs LA 70726 37 74 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dufrene Melissa 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fife Elizabeth 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gibson Monica 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hoffstetter Angela 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hulin Diane 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jenkins Laurel 8128 Florida Blvd Denham Springs LA 70726 37 74 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) King Jamie 8128 Florida Blvd Denham Springs LA 70726 29 71 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lacey Jennifer 8128 Florida Blvd Denham Springs LA 70726 29 71 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Owenby Ruth 8128 Florida Blvd Denham Springs LA 70726 37 74 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pennington Lauren 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Provosty Stacie 8128 Florida Blvd Denham Springs LA 70726 29 71 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Purser John 8128 Florida Blvd Denham Springs LA 70726 37 74 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Redmann Rondi 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sciortino Erin 8128 Florida Blvd Denham Springs LA 70726 37 74 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stephens Natasha 8128 Florida Blvd Denham Springs LA 70726 29 71 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Waldhelm Andrew 8128 Florida Blvd Denham Springs LA 70726 35 65 1 none 1 2 2 30483737 90934318THE PHYSICIAN'S ALLIANCE CORP (TPAC) Willis Tara 8128 Florida Blvd Denham Springs LA 70726 37 74 1 none 1 2 2 30483737 90934318FREEDOM PROSTHETICS LLC 8369 Florida Blvd Ste 7 Denham Springs LA 70726 40 54 1 none 1 2 1 30483989 90934076Quest Diagnostics 8369 Florida Boulevard Suite 9 Denham Springs LA 70726 20 30 1 none 1 1 2 30483989 90934076Baton Rouge Speech and Hearing Foundation Bourgoyne Tanya MA 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Brunet Sarah MA 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Devillier Melissa 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Esteve Brian M. MD 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Fairly Pam 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Henderson Patricia MA 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Juneau Melissa MA 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Kochergin Irina V. 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Macmurdo Cornelia G. 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Menge Natalee 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Sloan-Limmer Lisa MS 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056Baton Rouge Speech and Hearing Foundation Sprunger Margaret MA 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Baton Rouge Speech and Hearing Foundation Tassin Michelle A. 8393 Florida Blvd Denham Springs LA 70726 34 64 1 none 1 2 2 30483987 90934056LAHIRI-MUNIR DEVJANI OD Lahiri-Munir Devjani APOC 921 S. Range Ave. Denham Springs LA 70726 28 88 1 none 1 2 1 30473205 90956903ASSOCIATES IN PEDIATRIC DENTISTRY 13375 HIGHWAY 73 SUITE B GEISMAR LA 70734 32 48 1 none 1 1 2 30265465 90988285THE PHYSICIAN'S ALLIANCE CORP (TPAC) Laurent John Derek 1212 Riverview Blvd Ste 1050 Baton Rouge LA 70737 35 65 1 none 1 2 2 30209700 90930300Tiger Vision, LLC Lamendola Eva OD 1004 W Hwy 30 Ste A Gonzales LA 70737 28 88 1 none 1 2 2 30210951 90932041ACCENT OPTICAL INC 1004 W. Hwy 30 Ste 100 Gonzales LA 70737 20 18 1 none 1 2 2 30210951 90932041ACCENT OPTICAL INC Lamendola Eva M. 1004 W. Hwy 30 Ste 100 Gonzales LA 70737 28 88 1 none 1 2 2 30210951 90932041Tiger Vision, LLC Nelson Scott MD 1004 W. Hwy 30 Ste A Gonzales LA 70737 20 18 1 none 1 2 2 30210951 90932041Tiger Vision, LLC Haley Henry MD 1004 W. Hwy 30 Ste A Gonzales LA 70737 20 18 1 none 1 2 2 30210951 90932041Tiger Vision, LLC Hendricks Sean MD 1004 W. Hwy 30 Ste A Gonzales LA 70737 20 18 1 none 1 2 2 30210951 90932041THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ewing Thomas 1014 W St Clare Suite 3000 Gonzales LA 70737 20 34 1 none 1 2 2 30214951 90929801THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mathew K. 1014 W St Clare Suite 3015 Gonzales LA 70737 20 02 1 none 1 2 2 30225373 90953851THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ocmand Amy 1014 W St Clare Suite 3015 Gonzales LA 70737 20 02 1 none 1 2 2 30225373 90953851THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sharp Dawn 1014 W St Clare Suite 2010 Gonzales LA 70737 20 04 1 none 1 2 2 30282115 90953152THE PHYSICIAN'S ALLIANCE CORP (TPAC) Williams James 1014 W St Clare Suite 3015 Gonzales LA 70737 20 02 1 none 1 2 2 30225373 90953851Ascension Surgical Associates Manale Stephen MD 1014 W St Clare Blvd #3020 Gonzales LA 70737 20 02 1 None 2 1 2 30232827 90928806THE PHYSICIAN'S ALLIANCE CORP (TPAC) Petrie Scott 1014 W St Clare Blvd Suite 1020 Gonzales LA 70737 20 20 1 none 1 2 2 30208846 90962416LA HEMATOLOGY ONCOLOGY ASSOCIATES Bienvenu Bryan J. 1104 W. Hwy 30 Gonzales LA 70737 20 2H 1 >=18 1 2 2 30210938 90933147LA HEMATOLOGY ONCOLOGY ASSOCIATES Billings, III Frederic T. 1104 W. Hwy 30 Gonzales LA 70737 20 2H 1 >=18 1 2 2 30210938 90933147LA HEMATOLOGY ONCOLOGY ASSOCIATES Hanson David S. 1104 W. Hwy 30 Gonzales LA 70737 20 2H 1 >=18 1 2 2 30210938 90933147LA HEMATOLOGY ONCOLOGY ASSOCIATES Patten Judd E. 1104 W. Hwy 30 Gonzales LA 70737 20 2H 1 >=18 1 2 2 30210938 90933147LA HEMATOLOGY ONCOLOGY ASSOCIATES Schmeeckle Kellie D. 1104 W. Hwy 30 Gonzales LA 70737 20 2H 1 >=18 1 2 2 30210938 90933147LA HEMATOLOGY ONCOLOGY ASSOCIATES Spell Derrick W. 1104 W. Hwy 30 Gonzales LA 70737 20 2H 1 >=18 1 2 2 30210938 90933147THE PHYSICIAN'S ALLIANCE CORP (TPAC) Eldridge Scott PT 1212 Riverview Blvd Ste 1050 Gonzales LA 70737 35 65 1 none 1 2 2 30209700 90930300THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hope Courtney 1212 Riverview Blvd Ste 1050 Gonzales LA 70737 35 65 1 none 1 2 2 30209700 90930300THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gutierrez Gus 1212 Riverview Blvd Ste 1050 Gonzales LA 70737 35 65 1 none 1 2 2 30209700 90930300THE PHYSICIAN'S ALLIANCE CORP (TPAC) Martin Renee 1212 Riverview Blvd Ste 1050 Gonzales LA 70737 35 65 1 none 1 2 2 30209700 90930300THE PHYSICIAN'S ALLIANCE CORP (TPAC) Manale Stephen 1212 Riverview Blvd, Ste 3020 Gonzales LA 70737 20 02 1 none 1 2 2 30209700 90930300THE PHYSICIAN'S ALLIANCE CORP (TPAC) Couvillon Jane 1212 Riverview Rd Suite 1050 Gonzales LA 70737 35 65 1 none 1 2 2 30209700 90930300THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dyer Raymond 12320 Highway 44 Bldg 3-f Gonzales LA 70737 35 65 1 none 1 2 2 30247781 90920699THE PHYSICIAN'S ALLIANCE CORP (TPAC) Horton Haley 12320 Highway 44 Bldg 3-f Gonzales LA 70737 29 71 1 none 1 2 2 30247781 90920699THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lehmann Wendy ST 12320 Highway 44 Bldg 3-f Gonzales LA 70737 29 71 1 none 1 2 2 30247781 90920699THE PHYSICIAN'S ALLIANCE CORP (TPAC) Roberson Luanne 12320 Highway 44 Bldg 3-f Gonzales LA 70737 37 74 1 none 1 2 2 30247781 90920699THE PHYSICIAN'S ALLIANCE CORP (TPAC) Williamson Charlene 12320 Highway 44 Bldg 3-f Gonzales LA 70737 29 71 1 none 1 2 2 30247781 90920699THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nowakowski Bogdan L. 1429 Highway 30 Gonzales LA 70737 20 29 1 none 1 2 1 30210885 90906638THE PHYSICIAN'S ALLIANCE CORP (TPAC) Polek-nowakowska Halina 1429 Highway 30 Gonzales LA 70737 20 10 1 none 1 2 1 30210885 90906638RONALD D LANDRY DDS 1516 EAST HIGHWAY 30 GONZALES LA 70737 32 48 1 none 1 1 2 30211174 90905814THE PHYSICIAN'S ALLIANCE CORP (TPAC) Abramson Steven 1702 North Burnside #b Gonzales LA 70737 20 41 1 >=18 1 2 2 30246532 90920682THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hu Ben Hwa 1702 North Burnside #b Gonzales LA 70737 20 08 1 none 1 2 2 30246532 90920682THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wood Robert 1702 North Burnside #b Gonzales LA 70737 20 08 1 none 1 2 2 30246532 90920682ADULT MEDICINE INSTITUTE, INC Vazquez Carlos R. MD 1937 S. Burnside Ave Gonzales LA 70737 20 41 1 >=18 1 2 1 30217927 90920728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Adams Jason 1943a Burnside Avenue Gonzales LA 70737 20 16 1 >=16 1 2 1 30217898 90920728Ascension Optical Adams Edwin OD 2308 S Burnside Ave Gonzales LA 70737 28 88 1 None 2 1 1 30214473 90920395Ascension Optical Ascension Optical 2308 S Burnside Ave Gonzales LA 70737 75 88 1 None 2 1 2 30214473 90920395Southern Medical Associates Gboloo David K MD 2524 S Philippe Ave Gonzales LA 70737 20 41 1 <=99 2 1 1 30211747 90929258Southern Medical Associates Gboloo Gertrude MD 2524 S Philippe Ave Gonzales LA 70737 20 08 1 <=99 2 1 1 30211747 90929258THE PHYSICIAN'S ALLIANCE CORP (TPAC) Yalamanchili Jay 2524-b Philippe Ave Gonzales LA 70737 20 03 1 none 1 2 1 30211747 90929258Allergy and Asthma Clinic Yalamanchili Jayaprakash MD 2524-B S Philippe Ave Gonzales LA 70737 20 03 1 None 2 1 2 30211747 90929258Allergy and Asthma Clinic Yalamanchili Jayaprakash MD 2524-B S Philippe Ave Gonzales LA 70737 20 37 1 <=18 2 1 2 30211747 90929258THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gboloo David 2535 Phillipe Ave Gonzales LA 70737 20 41 1 >=18 1 2 1 30211631 90929574


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ascension Open MRI Ascension Open MRI 2622 S Ruby Ave Gonzales LA 70737 20 30 1 None 2 1 2 30210339 90939524ASCENSION OPEN MRI 2622 S. Ruby Ave. Gonzales LA 70737 20 30 1 none 1 2 2 30210339 90939524DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Collins Ted Z. MD 2622 South Ruby Street Gonzales LA 70737 20 30 1 none 1 2 2 30210339 90939524DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Greeson Charles S. MD 2622 South Ruby Street Gonzales LA 70737 20 30 1 none 1 2 1 30210339 90939524DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Hook Gina W. MD 2622 South Ruby Street Gonzales LA 70737 20 30 1 none 1 2 1 30210339 90939524DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Jones-Braswell Deana A. MD 2622 South Ruby Street Gonzales LA 70737 20 30 1 none 1 2 1 30210339 90939524DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Woody Mark W. MD 2622 South Ruby Street Gonzales LA 70737 20 30 1 none 1 2 1 30210339 90939524THE PHYSICIAN'S ALLIANCE CORP (TPAC) Abramson Steven 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 41 1 >=18 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Aguillard Paul C. 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 41 1 >=18 1 2 1 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barrient Dawn 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 37 1 <=18 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bodin Michael S 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 08 1 none 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dantoni James 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 08 1 none 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fraiche John 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 08 1 none 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guerin Madeleine 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 37 1 <=18 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hall Shawn 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 08 1 none 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hill Bunnie 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 41 1 >=18 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hirsch Michel 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 08 1 none 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kirby Diane 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 37 1 <=18 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Knapp John 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 41 1 >=18 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mathew Leya 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 37 1 <=18 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Narra Rao 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 41 1 >=18 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nguyen Paul 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 08 1 none 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Perkins Thomas 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 08 1 none 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Philippe Cherron 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 37 1 <=18 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Saunders Jean 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 08 1 none 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schexnayder Glenn 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 08 1 none 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Zitman Dawn 2647 S St. Elizabeth Blvd Gonzales LA 70737 20 37 1 <=18 1 2 2 30292074 90936728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boedefeld Robyn 2647 St Elizabeth Blvd Gonzales LA 70737 20 29 1 none 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brach Bernard 2647 St Elizabeth Blvd Gonzales LA 70737 20 29 1 none 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Donthineni Srivalli 2647 St Elizabeth Blvd Gonzales LA 70737 20 41 1 >=18 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fields Ronald 2647 St Elizabeth Blvd Gonzales LA 70737 20 29 1 none 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Haygood Bolling 2647 St Elizabeth Blvd Gonzales LA 70737 20 29 1 none 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hebert Cullen 2647 St Elizabeth Blvd Gonzales LA 70737 20 29 1 none 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kawji Haytham 2647 St Elizabeth Blvd Gonzales LA 70737 20 2E 1 none 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kearley Richard 2647 St Elizabeth Blvd Gonzales LA 70737 20 29 1 none 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Landry Scott 2647 St Elizabeth Blvd Gonzales LA 70737 20 29 1 none 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Malur Satyanarayan SEPS 2647 St Elizabeth Blvd Gonzales LA 70737 20 41 1 >=18 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Muzychka Daria 2647 St Elizabeth Blvd Gonzales LA 70737 20 41 1 >=18 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pearson, Jr. Charles 2647 St Elizabeth Blvd Gonzales LA 70737 20 29 1 none 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pirzadah Mohammad 2647 St Elizabeth Blvd Gonzales LA 70737 20 29 1 none 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Prempeh Avril-linda 2647 St Elizabeth Blvd Gonzales LA 70737 20 41 1 >=18 1 2 2 30254882 90901220THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vincent Brad 2647 St Elizabeth Blvd Gonzales LA 70737 20 29 1 none 1 2 2 30254882 90901220AUDIBEL HEARING HEALTHCARE 305-C S Burnside Gonzales LA 70737 34 64 1 none 1 2 2 30231129 90920816THE PHYSICIAN'S ALLIANCE CORP (TPAC) Caro Richard J. 609 E Worthey Road Gonzales LA 70737 20 08 1 None 1 2 2 30225553 90915614THE PHYSICIAN'S ALLIANCE CORP (TPAC) Monteyne Peter J. 609 E Worthey Road Gonzales LA 70737 20 08 1 None 1 2 1 30225553 90915614THE PHYSICIAN'S ALLIANCE CORP (TPAC) Twum-Antwi Yaw 723 E Hwy 30 Gonzales LA 70737 20 41 1 >=18 1 2 1 30210828 90914546MED-CARE OF ASCENSION LLC 908 West Orice Roth Rd Gonzales LA 70737 40 54 1 none 1 2 1 30218405 90930615Quest Diagnostics 18901 Greenwell Springs Rd Greenwell Springs LA 70739 20 30 1 none 1 1 2 30534611 90988005INNIS COMMUNITY HEALTH CENTER 6450 Louisiana Highway 1 Innis LA 70747 72 9L 1 none 1 2 2 30801555 91635944INNIS COMMUNITY HEALTH CENTER Breaux Jeryl P. 6450 Louisiana Highway 1 Innis LA 70747 20 08 1 >=18 1 2 2 30801555 91635944


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

INNIS COMMUNITY HEALTH CENTER Seferovic Admir 6450 Louisiana Highway I Innis LA 70747 20 08 1 none 1 2 2 30801555 91635944INNIS COMMUNITY HEALTH CENTER Williams Leon D. 6450 Louisiana Highway I Innis LA 70747 20 08 1 none 1 2 1 30801555 91635944THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nwabueze Nnadmi A 3050 Charles Dr Jackson LA 70748 20 41 1 >=18 1 2 1 30836381 91198178RKM PRIMARY CARE Connell Krista P. APRN 3501 Highway 10 Jackson LA 70748 78 08 1 none 1 2 1 30829700 91173800THE PHYSICIAN'S ALLIANCE CORP (TPAC) Greene Craig H. 216 Park St Krotz Springs LA 70750 20 08 1 None 1 2 2 30537063 91753304BR Family Med Center - Livingston Taylor James MD 13960 Florida Blvd Livingston LA 70754 20 08 1 None 2 1 2 30503199 90743918BR Family Med Center - Livingston Wilder Alonzo MD 13960 Florida Blvd Livingston LA 70754 20 08 1 None 2 1 2 30503199 90743918INNIS COMMUNITY HEALTH CENTER 3041 Fordoche Rd Livonia LA 70755 72 9L 1 none 1 2 2 30560075 91557336INNIS COMMUNITY HEALTH CENTER Breaux Jeryl P. 3041 Fordoche Rd Livonia LA 70755 20 08 1 >=18 1 2 2 30560075 91557336THE PHYSICIAN'S ALLIANCE CORP (TPAC) Breaux Jeryl 3041 Fordoche Rd Livonia LA 70755 20 41 1 >=18 1 2 2 30560075 91557336INNIS COMMUNITY HEALTH CENTER Seferovic Admir 3041 Fordoche Rd Livonia LA 70755 20 08 1 none 1 2 2 30560075 91557336THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walker Joan 3041 Fordoche Rd Livonia LA 70755 20 08 1 None 1 2 1 30560075 91557336INNIS COMMUNITY HEALTH CENTER Williams Leon D. 3041 Fordoche Rd Livonia LA 70755 20 08 1 none 1 2 1 30560075 91557336MARINGOUIN MEDICAL CENTER 77695 Wagley Rd Maringouin LA 70757 20 08 1 None 1 2 2 30491040 91532457THE PHYSICIAN'S ALLIANCE CORP (TPAC) Betrand Kellie 77695 Wagley Rd Maringouin LA 70757 78 08 1 None 1 2 2 30491040 91532457THE PHYSICIAN'S ALLIANCE CORP (TPAC) Doucet Donald 77695 Wagley Rd Maringouin LA 70757 20 08 1 None 1 2 2 30491040 91532457THE PHYSICIAN'S ALLIANCE CORP (TPAC) Elliott Leon 77695 Wagley Rd Maringouin LA 70757 20 08 1 None 1 2 1 30491040 91532457THE PHYSICIAN'S ALLIANCE CORP (TPAC) Newton Dedra 77695 Wagley Rd Maringouin LA 70757 78 08 1 None 1 2 2 30491040 91532457THE PHYSICIAN'S ALLIANCE CORP (TPAC) Oneal James 77695 Wagley Rd Maringouin LA 70757 20 08 1 None 1 2 2 30491040 91532457INNIS COMMUNITY HEALTH CENTER 8434 Pointe Coupee Rd Morganza LA 70759 72 9L 1 none 1 2 2 30714300 91543700INNIS COMMUNITY HEALTH CENTER Breaux Jeryl P. 8434 Pointe Coupee Rd Morganza LA 70759 20 08 1 >=18 1 2 2 30714300 91543700INNIS COMMUNITY HEALTH CENTER Seferovic Admir 8434 Pointe Coupee Rd Morganza LA 70759 20 08 1 none 1 2 2 30714300 91543700INNIS COMMUNITY HEALTH CENTER Williams Leon D. 8434 Pointe Coupee Rd Morganza LA 70759 20 08 1 none 1 2 1 30714300 91543700REGIONAL MEDICAL RENTAL & SALES 121 Court St. New Roads LA 70760 40 54 1 none 1 2 2 30693693 91432935REGIONAL MEDICAL RENTAL & SALES 121 Court Street New Roads LA 70760 40 54 1 none 1 2 2 30693693 91432935HANGER PROSTHETICS AND ORTHOTICS 124 New Roads St New Roads LA 70760 40 53 1 none 1 2 1 30693654 91433953HANGER PROSTHETICS AND ORTHOTICS 124 New Roads St New Roads LA 70760 40 53 1 none 1 2 1 30693654 91433953Hanger Prosthetics & Orthotics Inc. 124 New Roads Street New Roads LA 70760 40 53 1 none 1 1 2 30693654 91433953THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leblanc Brian 160 Hospital Rd. New Roads LA 70760 20 08 1 none 1 2 2 30682579 91462199THE PHYSICIAN'S ALLIANCE CORP (TPAC) Palecki Richard 2100 False River Drive, Ste A New Roads LA 70760 32 48 1 none 1 2 2 30683601 91459093POINTE COUPEE GENERAL HOSPITAL 2202 False River Drive New Roads LA 70760 60 86 1 none 1 2 2 30682587 91460945THE PHYSICIAN'S ALLIANCE CORP (TPAC) Malur Satyanarayan PT, CGH 2202 False River Drive New Roads LA 70760 20 41 1 >=18 1 2 2 30682587 91460945THE PHYSICIAN'S ALLIANCE CORP (TPAC) Aguillard Paul C. 2202 False River Road New Roads LA 70760 20 41 1 >=18 1 2 1 30682587 91460945Pointe Coupee Better Access Palecki Richard DPM 230 Roberts Dr Ste G New Roads LA 70760 32 48 1 None 1 1 2 30683178 91461872JAMES CHRISTOPHER Christopher James L. MD 230 Roberts Drive, Ste. F New Roads LA 70760 20 08 1 None 1 2 2 30683178 91461872POINTE COUPEE BETTER ACCESS Elliott Leone 230 Roberts Drive, Ste. G New Roads LA 70760 20 08 1 none 1 2 1 30683178 91461872POINTE COUPEE BETTER ACCESS Palecki Richard 230 Roberts Drive, Ste. G New Roads LA 70760 32 48 1 none 1 2 2 30683178 91461872THE PHYSICIAN'S ALLIANCE CORP (TPAC) Elliott, Jr. Leone 230 Roberts Rd Suite A New Roads LA 70760 20 08 1 None 1 2 1 30683178 91461872THE PHYSICIAN'S ALLIANCE CORP (TPAC) Picard Jason 230 Roberts Rd Suite A New Roads LA 70760 20 41 1 >=18 1 2 2 30683178 91461872THE PHYSICIAN'S ALLIANCE CORP (TPAC) Doucet Donald 230 Roberts Rd, Ste I New Roads LA 70760 20 41 1 >=18 1 2 2 30683178 91461872THE PHYSICIAN'S ALLIANCE CORP (TPAC) Picard Jason 230 Roberts Rd, Ste I New Roads LA 70760 20 41 1 >=18 1 2 2 30683178 91461872THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smothers Carol 230 Roberts Rd. Ste A New Roads LA 70760 20 08 1 none 1 2 2 30683178 91461872THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mclemore Carl 230 Roberts Rd. Ste B New Roads LA 70760 20 08 1 none 1 2 2 30683178 91461872THE PHYSICIAN'S ALLIANCE CORP (TPAC) Montelaro Louis 230 Roberts Rd. Ste E New Roads LA 70760 20 08 1 none 1 2 2 30683178 91461872THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rachal Paul 230 Roberts Rd. Ste H New Roads LA 70760 20 08 1 none 1 2 2 30683178 91461872Robert J Geier OD Geier Robert J OD 250 Hospital Rd New Roads LA 70760 20 88 1 None 1 2 2 30682915 91462481AUDIBEL HEARING HEALTHCARE 2506 False River Rd New Roads LA 70760 34 64 1 none 1 2 2 30678978 91466342THE PHYSICIAN'S ALLIANCE CORP (TPAC) Broussard Latresia 331 Hospital Rd New Roads LA 70760 30 35 1 none 1 2 1 30683294 91463190Pointe Coupee Homebound Health Services 350 Hospital Road New Roads LA 70760 44 75 1 none 1 2 2 30683614 91463062THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brown Andrea 23845 Church Plaquemine LA 70764 20 08 1 None 1 2 1 30287676 91231563


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Anointed Family Medicine Brown Andrea B MD 23845 Church St Plaquemine LA 70764 20 08 1 >34 2 1 2 30287676 91231563THE PHYSICIAN'S ALLIANCE CORP (TPAC) Marshall Nancy 24160 Railroad Ave Plaquemine LA 70764 30 35 1 none 1 2 2 30283328 91232200FAMILY FIRST MEDICAL CLINIC Edwards Antonio D. 25073 Hwy 1 South Plaquemine LA 70764 20 08 1 none 1 2 1 30275492 91223338THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fitch Andriette M. 58155 Chinn Street Suite B Plaquemine LA 70764 20 41 1 >=18 1 2 2 30281878 91234559SYNERGY HOME CARE-CAPITOL REGION INC 58725 Belleview Rd Ste A-3 Plaquemine LA 70764 44 75 1 none 1 2 2 30272121 91239567Reddy Family Medical Clinic Reddy Nagaratna MD 58725 Belleview Rd Plaquemine LA 70764 20 08 1 None 1 2 2 30272121 91239567REDDY FAMILY MEDICAL CLINIC / Family Medical Clinic 58725 Belleview Rd. Plaquemine LA 70764 79 94 1 none 1 2 2 30272121 91239567REDDY FAMILY MEDICAL CLINIC / Family Medical Clinic Reddy Nagaratna MD 58725 Belleview Rd. Plaquemine LA 70764 20 08 1 None 1 2 1 30272121 91239567PRIME HEALTH LLC 59295 River West Dr., Ste. C Plaquemine LA 70764 79 94 1 none 1 2 1 30262669 91245382PRIME HEALTH LLC Jackson Paul A. 59295 River West Dr., Ste. C Plaquemine LA 70764 20 08 1 none 1 2 2 30262669 91245382THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dean Kevin 59315 River West Drive Suite C Plaquemine LA 70764 20 41 1 >=18 1 2 2 30262348 91245736THE PHYSICIAN'S ALLIANCE CORP (TPAC) Adhvaryu Dhaval 59335 Riverwest Drive E Plaquemine LA 70764 20 02 1 none 1 2 1 30261943 91246011Dennis L Surratt OD Surratt Dennis L OD 3255 Hwy 1 S Port Allen LA 70767 28 88 1 None 2 1 2 30419903 91220779THE PHYSICIAN'S ALLIANCE CORP (TPAC) Padgett Philip G. 610 N Jefferson St Port Allen LA 70767 20 08 1 None 1 2 2 30457499 91205560RKM PRIMARY CARE Chaney John G. APRN 751 Court Street Port Allen LA 70767 78 08 1 >=18 1 2 2 30452179 91208652RKM PRIMARY CARE Johnson Meredith V. APRN 751 Court Street Port Allen LA 70767 78 08 1 none 1 2 1 30452179 91208652RKM PRIMARY CARE McKnight George T. MD 751 Court Street Port Allen LA 70767 20 41 1 none 1 2 2 30452179 91208652THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reddy Santhosh 970 N Alexander Ave Port Allen LA 70767 20 08 1 None 1 2 1 30461127 91210703SANTHOSH REDDY Reddy Santhosh K. 970 N. Alexander Ave Port Allen LA 70767 20 41 1 none 1 2 1 30461127 91210703THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cozic Angelique 14350 Hwy 73 Prairieville LA 70769 78 08 1 >=18 1 2 2 30281012 90982192THE PHYSICIAN'S ALLIANCE CORP (TPAC) Juneau Kyle 14350 Hwy 73 Prairieville LA 70769 78 79 1 >=18 1 2 2 30281012 90982192THE PHYSICIAN'S ALLIANCE CORP (TPAC) Neal Norman 14350 Hwy 73 Prairieville LA 70769 20 41 1 >=18 1 2 2 30281012 90982192Ochsner Clinic Russo Aldo J. 16220 Airline Highway Suite A Prairieville LA 70769 20 10 1 none 1 2 2 30304959 90973599Ochsner Clinic Pasqua Claire M. 16260 Airline Highway Suite A Prairieville LA 70769 78 08 1 None 1 2 2 30305649 90974081Oak Grove Family Practice Curtis Elizabeth MD 17505 Old Jefferson Hwy Prairieville LA 70769 20 08 1 None 2 1 2 30322279 90976986Oak Grove Family Practice Warner Naysha MD 17505 Old Jefferson Hwy Prairieville LA 70769 20 08 1 None 2 1 2 30322279 90976986Oak Grove Family Practice Wells Tina MD 17505 Old Jefferson Hwy Prairieville LA 70769 20 08 1 None 2 1 2 30322279 90976986Oak Grove Family Practice Yorek Michael W MD 17505 Old Jefferson Hwy Prairieville LA 70769 20 08 1 None 2 1 2 30322279 90976986ASSOCIATES IN PEDIATRIC DENTISTRY 17534 OLD JEFFERSON HIGHWAY SUITE C1 PRAIRIEVILLE LA 70769 32 48 1 none 1 1 2 30322608 90976720THE PHYSICIAN'S ALLIANCE CORP (TPAC) Blackstone Chris 17534 Old Jefferson Hwy A-1 Prairieville LA 70769 35 65 1 none 1 2 2 30322608 90976720THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bock David 17534 Old Jefferson Hwy A-1 Prairieville LA 70769 35 65 1 none 1 2 2 30322608 90976720THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mula Mitchell 17534 Old Jefferson Hwy A-1 Prairieville LA 70769 35 65 1 none 1 2 2 30322608 90976720THE PHYSICIAN'S ALLIANCE CORP (TPAC) Howell Michael 17609 Old Jefferson Hwy Prairieville LA 70769 20 08 1 none 1 2 2 30323237 90977352FUNCTIONAL MOBILITY SYSTEMS 37326 Commerce Lane Prairieville LA 70769 40 54 1 none 1 2 1 30328444 90986438Ochsner Clinic Baird William H. 16220 Airline Highway Prairieville, LA 70769 20 41 1 >=18 1 2 2 30304959 90973599Ochsner Clinic Hart Robert I. 16220 Airline Highway Prairieville, LA 70769 20 41 1 >=18 1 2 2 30304959 90973599Ochsner Clinic Love Melissa B. 16220 Airline Highway Prairieville, LA 70769 20 08 1 None 1 2 2 30304959 90973599Ochsner Clinic Michael Kendra 16220 Airline Highway Prairieville, LA 70769 20 37 1 <=18 1 2 2 30304959 90973599Ochsner Clinic Turner Joseph P. 16220 Airline Highway Prairieville, LA 70769 20 08 1 None 1 2 2 30304959 90973599Lawrence B Schneider MD Schneider Lawrence B MD 10289 Gould St Box 850 Ste C St Francisville LA 70775 20 08 1 None 1 1 2 30832514 91419216ALTERNATIVE FOOT CLINIC Davis Alex J. 10290 Gould Dr St Francisville LA 70775 32 48 1 none 1 2 1 30971054 91391285WEST FELICIANA PARISH HOSPITAL 5266 Commerce Street St. Francisville LA 70775 60 86 1 none 1 2 2 30778905 91371469DANIEL SERVICES, LLC 5326 Oak Street St. Francisville LA 70775 20 08 1 None 1 2 1 30787869 91370113DANIEL SERVICES, LLC Bobo Dewana NP 5326 Oak Street St. Francisville LA 70775 78 08 1 none 1 2 2 30787869 91370113THE PHYSICIAN'S ALLIANCE CORP (TPAC) Daniel Chaillie 5326 Oak Street St. Francisville LA 70775 20 08 1 None 1 2 1 30787869 91370113DANIEL SERVICES, LLC Hayden Patty 5326 Oak Street St. Francisville LA 70775 78 08 1 none 1 2 2 30787869 91370113THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lindsey Timothy 5326 Oak Street St. Francisville LA 70775 20 08 1 None 1 2 1 30787869 91370113DANIEL SERVICES, LLC Scroggs Margaret 5326 Oak Street St. Francisville LA 70775 78 08 1 none 1 2 2 30787869 91370113ST GABRIEL HEALTH CLINIC INC 1825 Hwy 30 St. Gabriel LA 70776 72 9L 1 none 1 2 2 30241900 91050600ST GABRIEL HEALTH CLINIC INC 3285 Hwy 75 St. Gabriel LA 70776 72 9L 1 none 1 2 2 30273467 91119426


LOI Contract STP*

Geocoding



Provider Type

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New Patient

Age Restricti

onPCP Link

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2nd Line of Address

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ST GABRIEL HEALTH CLINIC INC 5760 Monticello St St. Gabriel LA 70776 72 9L 1 none 1 2 2 30259102 91099998RKM PRIMARY CARE Hall Cynthia APRN 3170 Church Street Slaughter LA 70777 78 08 1 none 1 2 2 30718375 91148138THE PHYSICIAN'S ALLIANCE CORP (TPAC) Baker Tamara 29419 Walker South Road Walker LA 70785 37 74 1 none 1 2 2 30482704 90863358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Buggage Juanta 29419 Walker South Road Walker LA 70785 29 71 1 none 1 2 2 30482704 90863358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cui Yongqin 29419 Walker South Road Walker LA 70785 37 74 1 none 1 2 2 30482704 90863358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Harper Melody 29419 Walker South Road Walker LA 70785 35 65 1 none 1 2 2 30482704 90863358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Humphrey Joshua 29419 Walker South Road Walker LA 70785 37 74 1 none 1 2 2 30482704 90863358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcgee Helen 29419 Walker South Road Walker LA 70785 37 74 1 none 1 2 2 30482704 90863358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moore Katie 29419 Walker South Road Walker LA 70785 37 74 1 none 1 2 2 30482704 90863358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rivet Clyde 29419 Walker South Road Walker LA 70785 35 65 1 none 1 2 2 30482704 90863358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sanders Brenda 29419 Walker South Road Walker LA 70785 35 65 1 none 1 2 2 30482704 90863358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Scherr Joel 29419 Walker South Road Walker LA 70785 35 65 1 none 1 2 2 30482704 90863358THE PHYSICIAN'S ALLIANCE CORP (TPAC) Seiler Karen 29419 Walker South Road Walker LA 70785 29 71 1 none 1 2 2 30482704 90863358Reddy Family Medical Clinic Reddy Nagaratna MD 32985 Bowie St White Castle LA 70788 20 08 1 None 1 2 2 30160891 91150155REDDY FAMILY MEDICAL CLINIC / Family Medical Clinic 32985 Bowie St. White Castle LA 70788 79 94 1 none 1 2 2 30160891 91150155REDDY FAMILY MEDICAL CLINIC / Family Medical Clinic Reddy Nagaratna MD 32985 Bowie St. White Castle LA 70788 20 08 1 None 1 2 1 30160891 91150155HALKOVIC NICOLE MDC Halkovic Nicole M. DC 1121 Church St. Suite B Zachary LA 70791 30 35 1 none 1 2 1 30654499 91190053THE PHYSICIAN'S ALLIANCE CORP (TPAC) Halkovic Nicole 1121-b Church St Zachary LA 70791 20 35 1 none 1 2 1 30654499 91190053SOUTHEAST COMMUNITY HEALTH SYSTEM 13211 Jackson Rd Zachary LA 70791 72 9L 1 none 1 2 2 30685758 91024727SOUTHEAST COMMUNITY HEALTH SYSTEM Ballard Eileen 13211 Jackson Rd Zachary LA 70791 20 37 1 <=18 1 2 2 30685758 91024727SOUTHEAST COMMUNITY HEALTH SYSTEM Cecchini Heather 13211 Jackson Rd Zachary LA 70791 78 79 1 >=18 1 2 2 30685758 91024727SOUTHEAST COMMUNITY HEALTH SYSTEM Evans LaDonna 13211 Jackson Rd Zachary LA 70791 78 08 1 >=18 1 2 2 30685758 91024727SOUTHEAST COMMUNITY HEALTH SYSTEM Fontenot Deborah 13211 Jackson Rd Zachary LA 70791 20 08 1 None 1 2 2 30685758 91024727SOUTHEAST COMMUNITY HEALTH SYSTEM Kakazu Mario 13211 Jackson Rd Zachary LA 70791 20 08 1 None 1 2 2 30685758 91024727SOUTHEAST COMMUNITY HEALTH SYSTEM Miles Daraka 13211 Jackson Rd Zachary LA 70791 78 08 1 >=18 1 2 2 30685758 91024727SOUTHEAST COMMUNITY HEALTH SYSTEM Nanjappa Nagaraji 13211 Jackson Rd Zachary LA 70791 20 1T 1 none 1 2 2 30685758 91024727SOUTHEAST COMMUNITY HEALTH SYSTEM Smith Tammy 13211 Jackson Rd Zachary LA 70791 78 08 1 None 1 2 2 30685758 91024727THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brown Clayton 2335 Church St Ste F Zachary LA 70791 20 10 1 none 1 2 2 30653121 91178763LANE REGIONAL MEDICAL CENTER Gruner Jeffrey MD 2335 Church St. Ste E Zachary LA 70791 20 02 1 none 1 2 2 30653121 91178763Moreau Physical Therapy Bozant Ryan 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763Moreau Physical Therapy Chamberlain Jerry 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763Moreau Physical Therapy Faucheux Christina 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763Moreau Physical Therapy Giles Robin 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763Moreau Physical Therapy Grunewald Kristopher 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763Moreau Physical Therapy Jones Althea 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763Moreau Physical Therapy LeBlanc Kyle 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763Moreau Physical Therapy Martin Murphy Jude 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763Moreau Physical Therapy Moreau, III Alvin C. 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 1 30653121 91178763Moreau Physical Therapy Moreau, Jr Al C. 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763Moreau Physical Therapy Pavy Mary Katherine 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763Moreau Physical Therapy Williams Kara 2335 Church St. Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763THE PHYSICIAN'S ALLIANCE CORP (TPAC) Grunewald Kristopher 2335 Church Street Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hayden Patty 2335 Church Street Suite E Zachary LA 70791 78 08 1 None 1 2 2 30653121 91178763THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jones Althea 2335 Church Street Suite G Zachary LA 70791 35 65 1 none 1 2 2 30653121 91178763THE PHYSICIAN'S ALLIANCE CORP (TPAC) Amacker Kemp 2335 Church Street, Ste. E Zachary LA 70791 20 08 1 None 1 2 2 30653121 91178763THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cosse Michelle 2335 Church Street, Ste. E Zachary LA 70791 20 08 1 None 1 2 2 30653121 91178763THE PHYSICIAN'S ALLIANCE CORP (TPAC) Elkins Reagan 2335 Church Street, Ste. E Zachary LA 70791 20 08 1 None 1 2 2 30653121 91178763THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gravois Wayne D. 2335 Church Street, Ste. E Zachary LA 70791 20 08 1 None 1 2 2 30653121 91178763THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gruner Jeffrey 2335 Church Street, Ste. E Zachary LA 70791 20 02 1 none 1 2 2 30653121 91178763EYE CARE COSMETIC CENTER Allemond Jason P. OD 2421 Church St Zachary LA 70791 28 88 1 none 1 2 2 30653038 91178080


LOI Contract STP*

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Provider Type

Specialty Code

New Patient

Age Restricti

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EYE CARE COSMETIC CENTER Caullard Glenn M. OD 2421 Church St Zachary LA 70791 28 88 1 none 1 2 2 30653038 91178080EYE CARE COSMETIC CENTER Rogers Kevin A. OD 2421 Church St Zachary LA 70791 28 88 1 none 1 2 2 30653038 91178080EYE CARE COSMETIC CENTER Toomey Shannon C. 2421 Church St Zachary LA 70791 28 88 1 none 1 2 2 30653038 91178080EYE CARE COSMETIC CENTER Williamson Baron J. MD 2421 Church St Zachary LA 70791 20 18 1 none 1 2 2 30653038 91178080COMED RESPIRATORY & MEDICAL E 3610 Hwy 19 Zachary LA 70791 40 54 1 none 1 2 2 30640422 91153957THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moosa Yunus 4242 Hwy 19 Suite A Zachary LA 70791 20 06 1 none 1 2 2 30645231 91150736LA HEMATOLOGY ONCOLOGY ASSOCIATES Bienvenu Bryan J. 4758 W. Park Drive Zachary LA 70791 20 2H 1 >=18 1 2 2 30648751 91136375LA HEMATOLOGY ONCOLOGY ASSOCIATES Billings, III Frederic T. 4758 W. Park Drive Zachary LA 70791 20 2H 1 >=18 1 2 2 30648751 91136375LA HEMATOLOGY ONCOLOGY ASSOCIATES Hanson David S. 4758 W. Park Drive Zachary LA 70791 20 2H 1 >=18 1 2 2 30648751 91136375LA HEMATOLOGY ONCOLOGY ASSOCIATES Patten Judd E. 4758 W. Park Drive Zachary LA 70791 20 2H 1 >=18 1 2 2 30648751 91136375LA HEMATOLOGY ONCOLOGY ASSOCIATES Schmeeckle Kellie D. 4758 W. Park Drive Zachary LA 70791 20 2H 1 >=18 1 2 2 30648751 91136375LA HEMATOLOGY ONCOLOGY ASSOCIATES Spell Derrick W. 4758 W. Park Drive Zachary LA 70791 20 2H 1 >=18 1 2 2 30648751 91136375THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wyatt David 4801 Mchugh Road Suite C Zachary LA 70791 20 20 1 none 1 2 2 30641103 91140425LEWIS LYDIA D MD Lewis Lydia D. 4819 W. Park Drive Zachary LA 70791 20 16 1 >=16 1 2 1 30648917 91136676THE PHYSICIAN'S ALLIANCE CORP (TPAC) Richey Thomas H. 4851 West Park Dr Zachary LA 70791 20 02 1 none 1 2 2 30648990 91136668THE PHYSICIAN'S ALLIANCE CORP (TPAC) Simonson Matthew J 5626 Main Street Zachary LA 70791 30 35 1 none 1 2 2 30647245 91146445Belanger Eye Care Belanger Chad OD 5801 Main St Zachary LA 70791 28 88 1 None 2 1 2 30648239 91144265THE PHYSICIAN'S ALLIANCE CORP (TPAC) Surek Christopher DO 6110 East Main Street D Zachary LA 70791 19 04 1 none 1 2 1 30662970 91191467THE PHYSICIAN'S ALLIANCE CORP (TPAC) Elbourne Keith 6110 Main Street Suite A Zachary LA 70791 20 16 1 >=16 1 2 1 30649394 91140386THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gruner Jeffrey 6180 Main St, Ste B Zachary LA 70791 20 02 1 none 1 2 2 30649668 91139644THE PHYSICIAN'S ALLIANCE CORP (TPAC) Taylor Jonathan 6180 Main Street Suite A Zachary LA 70791 20 02 1 none 1 2 2 30649668 91139644LANE REGIONAL MEDICAL CENTER 6300 Main St Zachary LA 70791 44 75 1 none 1 2 2 30650009 91138168LANE REGIONAL MEDICAL CENTER 6300 Main St Zachary LA 70791 60 86 1 none 1 2 2 30650009 91138168DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Collins Ted Z. MD 6300 Main Street Zachary LA 70791 20 30 1 none 1 2 2 30650009 91138168DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Greeson Charles S. MD 6300 Main Street Zachary LA 70791 20 30 1 none 1 2 1 30650009 91138168DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Hook Gina W. MD 6300 Main Street Zachary LA 70791 20 30 1 none 1 2 1 30650009 91138168DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Jones-Braswell Deana A. MD 6300 Main Street Zachary LA 70791 20 30 1 none 1 2 1 30650009 91138168DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Woody Mark W. MD 6300 Main Street Zachary LA 70791 20 30 1 none 1 2 1 30650009 91138168MedAmerica LLC Khelghati Amrullah MD 9305 Main St Ste D Zachary LA 70791 20 37 1 <=18 1 2 2 30649122 91111162BATON ROUGE PRIMARY CARE COLLABORATIVE 153 N. 17th St Baton Rouge LA 70802 72 9L 1 none 1 2 2 30448421 91171642BATON ROUGE PRIMARY CARE COLLABORATIVE Amacker Shannon 153 N. 17th St Baton Rouge LA 70802 20 08 1 None 1 2 2 30448421 91171642BATON ROUGE PRIMARY CARE COLLABORATIVE Anderson Danita MD 153 N. 17th St Baton Rouge LA 70802 20 08 1 None 1 2 2 30448421 91171642BATON ROUGE PRIMARY CARE COLLABORATIVE Bland Stacie 153 N. 17th St Baton Rouge LA 70802 78 08 1 None 1 2 2 30448421 91171642THE PHYSICIAN'S ALLIANCE CORP (TPAC) Larsen Scott 160 N. 8th Street Baton Rouge LA 70802 35 65 1 none 1 2 2 30447962 91182557THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lejeune Geof 160 N. 8th Street Baton Rouge LA 70802 35 65 1 none 1 2 2 30447962 91182557STAN MAYS Mays Stan J. MD 4242 Gus Young Ave. Baton Rouge LA 70802 20 08 1 None 1 2 1 30461867 91147650Baton Rouge Speech and Hearing Foundation Juneau Melissa MA 534 West Roosevelt St. Baton Rouge LA 70802 34 64 1 none 1 2 2 30421835 91182732Baton Rouge Speech and Hearing Foun Bourgoyne Tanya MA 535 Roosevelt St Baton Rouge LA 70802 39 71 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Devillier Melissa BS-OT 535 Roosevelt St Baton Rouge LA 70802 29 54 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Devillier Melissa BS-OT 535 Roosevelt St Baton Rouge LA 70802 37 74 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Henderson Patricia MA 535 Roosevelt St Baton Rouge LA 70802 29 54 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Henderson Patricia MA 535 Roosevelt St Baton Rouge LA 70802 39 71 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Juneau Melissa MA 535 Roosevelt St Baton Rouge LA 70802 29 54 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Juneau Melissa MA 535 Roosevelt St Baton Rouge LA 70802 39 71 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Sloan-Limmer Lisa MA 535 Roosevelt St Baton Rouge LA 70802 39 71 1 <21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Spunger Margaret MA 535 Roosevelt St Baton Rouge LA 70802 29 54 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Spunger Margaret MA 535 Roosevelt St Baton Rouge LA 70802 39 71 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Tassin Michelle MA 535 Roosevelt St Baton Rouge LA 70802 29 54 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foun Tassin Michelle MA 535 Roosevelt St Baton Rouge LA 70802 39 71 1 <=21 2 1 2 30421964 91176803Baton Rouge Speech and Hearing Foundation Bourgoyne Tanya MA 535 West Roosevelt St Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Baton Rouge Speech and Hearing Foundation Esteve Brian M. MD 535 West Roosevelt St Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727Baton Rouge Speech and Hearing Foundation Fairly Pam 535 West Roosevelt St Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727Baton Rouge Speech and Hearing Foundation Macmurdo Cornelia G. 535 West Roosevelt St Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727Baton Rouge Speech and Hearing Foundation Menge Natalee 535 West Roosevelt St Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727Baton Rouge Speech and Hearing Foundation Sloan-Limmer Lisa MS 535 West Roosevelt St Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727Baton Rouge Speech and Hearing Foundation Sprunger Margaret MA 535 West Roosevelt St Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727Baton Rouge Speech and Hearing Foundation Tassin Michelle A. 535 West Roosevelt St Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727Baton Rouge Speech and Hearing Foundation Brunet Sarah MA 535 West Roosevelt St. Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727Baton Rouge Speech and Hearing Foundation Devillier Melissa 535 West Roosevelt St. Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727Baton Rouge Speech and Hearing Foundation Henderson Patricia MA 535 West Roosevelt St. Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727Baton Rouge Speech and Hearing Foundation Kochergin Irina V. 535 West Roosevelt St. Baton Rouge LA 70802 34 64 1 none 1 2 2 30421561 91182727THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hudson Janice 950 E Washington Street So Br Clinic Baton Rouge LA 70802 20 08 1 none 1 2 2 30431015 91175902PARISH ANESTHESIA OF BATON ROUGE Anderson Kevin J. MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Berrigan Donald Patrick CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Bienasz Stanley Michael MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Bollich Amiee Angelle CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Brignac Jennifer Lebert CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Castille Ross Victor CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Crochet Beth C. CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Dang Son Manh MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE David Susan MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Davidson Joshua Burton CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Dunaway Stephanie Underwood CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Dunn, II Michael Bernard MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Eagleton Bernard E. MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Eyre Byron MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Freeman James Carlton MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Galliano Dante Juan MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Gaudin Rachel Lynn CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Hanks Michael D. MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Hardy Kyle David CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Hart Sarah Fields CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Hatch Grass Joellyn Mary CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Jones Jeremy CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Langley Brigitte Hernandez CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Legendre Adrianne CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Legnon Christopher Michael CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Maynard Timothy S. CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Morris, III Hershel Fisk CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Mynard Catherine Moss CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Odom Patrick Dickerson MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Olivier, III Roumay CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Pepper Clinton Stuart CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Rosinia Francis Anthony MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Saulny Marie Christina MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Schnebelen Kyle CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Scofield Sharon CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Sonnier Corey James CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Steele Barry Alan MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Stuprich Anthony V. CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

PARISH ANESTHESIA OF BATON ROUGE Sukkar Mohammed Salim MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Tahir Ash H. MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Thibodeaux Wayne Joseph MD 3600 Florida Avenue Baton Rouge LA 70803 20 05 1 none 1 2 2 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Vickers Michael Kent CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475PARISH ANESTHESIA OF BATON ROUGE Welch Clay CRNA 3600 Florida Avenue Baton Rouge LA 70803 91 05 1 none 1 2 1 30450201 91154475GOLDEN MEDICAL EQUIPMENT & SUPPLY 2708 Wooddale Blvd, Ste A, Rm 1 Baton Rouge LA 70805 40 54 1 none 1 2 2 30473842 91115836ROBERT FELDMAN Feldman Robert E. MD 4245 Winbourne Avenue Baton Rouge LA 70805 20 37 1 <=18 1 2 1 30478748 91147243THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cowart Ashley A. 5439 Airline Highway N. Baton Rouge Clini Baton Rouge LA 70805 20 16 1 >=16 1 2 2 30506979 91136362THE PHYSICIAN'S ALLIANCE CORP (TPAC) Day Harry 5439 Airline Hwy N. Baton Rouge Clini Baton Rouge LA 70805 20 41 1 >=18 1 2 2 30506979 91136362THE PHYSICIAN'S ALLIANCE CORP (TPAC) Heck Madeleine 5439 Airline Hwy N. Baton Rouge Clini Baton Rouge LA 70805 20 2I 1 none 1 2 2 30506979 91136362THE PHYSICIAN'S ALLIANCE CORP (TPAC) Truehill-Wellington Briana 5439 Airline Hwy N. Baton Rouge Clini Baton Rouge LA 70805 20 16 1 >=16 1 2 2 30506979 91136362THE PHYSICIAN'S ALLIANCE CORP (TPAC) Venters Charmaine 5825 Airline Baton Rouge LA 70805 20 37 1 <=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) 5825 Airline Dr Baton Rouge LA 70805 20 05 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) 5825 Airline Dr Baton Rouge LA 70805 65 22 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allain Brent W. 5825 Airline Dr Baton Rouge LA 70805 20 02 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allain, Jr Brent 5825 Airline Dr Baton Rouge LA 70805 20 02 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allain, Jr. Brent 5825 Airline Dr Baton Rouge LA 70805 20 02 1 none 1 2 1 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Anderson William A. 5825 Airline Dr Baton Rouge LA 70805 20 10 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Arriaga Moises 5825 Airline Dr Baton Rouge LA 70805 20 04 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bankston Albert 5825 Airline Dr Baton Rouge LA 70805 20 20 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barefield Darren 5825 Airline Dr Baton Rouge LA 70805 20 2K 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barkemeyer Charles 5825 Airline Dr Baton Rouge LA 70805 20 13 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bienvenu Bryan 5825 Airline Dr Baton Rouge LA 70805 20 2H 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Blue Kenneth 5825 Airline Dr Baton Rouge LA 70805 20 34 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bourgeois Michael 5825 Airline Dr Baton Rouge LA 70805 20 16 1 >=16 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Byrd Richard 5825 Airline Dr Baton Rouge LA 70805 20 02 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Byrd Richard L. 5825 Airline Dr Baton Rouge LA 70805 20 10 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cassidy William 5825 Airline Dr Baton Rouge LA 70805 20 10 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cataldo Vince D 5825 Airline Dr Baton Rouge LA 70805 20 2H 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cauble Stephanie M. 5825 Airline Dr Baton Rouge LA 70805 20 41 1 >=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cucurull Elena 5825 Airline Dr Baton Rouge LA 70805 20 2M 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dileo Michael 5825 Airline Dr Baton Rouge LA 70805 20 04 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Espinoza Luis R. 5825 Airline Dr Baton Rouge LA 70805 20 2M 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Estes Jacob 5825 Airline Dr Baton Rouge LA 70805 20 16 1 >=16 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Failla Paul 5825 Airline Dr Baton Rouge LA 70805 20 06 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Failla Paul J. 5825 Airline Dr Baton Rouge LA 70805 20 29 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ferachi Larry G. 5825 Airline Dr Baton Rouge LA 70805 20 20 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Frederic Jeffrey 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Frederic Stephanie 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fusilier Gregory 5825 Airline Dr Baton Rouge LA 70805 20 10 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gamble Lisa L. 5825 Airline Dr Baton Rouge LA 70805 20 29 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gardner Renee V. 5825 Airline Dr Baton Rouge LA 70805 20 37 1 <=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gick Stephen 5825 Airline Dr Baton Rouge LA 70805 20 20 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Godke John R. 5825 Airline Dr Baton Rouge LA 70805 20 29 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Golden Barbara J. 5825 Airline Dr Baton Rouge LA 70805 20 13 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gordon Stewart 5825 Airline Dr Baton Rouge LA 70805 20 37 1 <=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hanson David S. 5825 Airline Dr Baton Rouge LA 70805 20 2H 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hollman Jay L. 5825 Airline Dr Baton Rouge LA 70805 20 06 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Howell Joseph K. 5825 Airline Dr Baton Rouge LA 70805 20 10 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jagneaux Tonja 5825 Airline Dr Baton Rouge LA 70805 20 29 1 none 1 2 2 30503906 91132323


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jagneaux Tonya 5825 Airline Dr Baton Rouge LA 70805 20 29 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jensen Deborah 5825 Airline Dr Baton Rouge LA 70805 20 16 1 >=16 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson Jolene K. 5825 Airline Dr Baton Rouge LA 70805 20 2E 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kilpatrick Robin 5825 Airline Dr Baton Rouge LA 70805 20 2E 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lauret Dean 5825 Airline Dr Baton Rouge LA 70805 20 41 1 >=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee William 5825 Airline Dr Baton Rouge LA 70805 20 02 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lin James 5825 Airline Dr Baton Rouge LA 70805 20 04 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meek, Jr Tom 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323DERMATOLOGY CLINIC Meek, Jr. Tom J. MD 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moore Sheila 5825 Airline Dr Baton Rouge LA 70805 20 2H 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mora Ricardo G. 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morrison John 5825 Airline Dr Baton Rouge LA 70805 20 02 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nesbitt Lee 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Neumann Duane 5825 Airline Dr Baton Rouge LA 70805 20 16 1 >=16 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nuss Daniel W. 5825 Airline Dr Baton Rouge LA 70805 20 2H 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Payne Thomas N. 5825 Airline Dr Ekl Medical Ctr Baton Rouge LA 70805 20 16 1 >=16 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Perkowski Paul 5825 Airline Dr Baton Rouge LA 70805 20 02 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Perkowski Paul 5825 Airline Dr Baton Rouge LA 70805 20 33 1 none 1 2 1 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Poche George 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pou Anna M. 5825 Airline Dr Baton Rouge LA 70805 20 04 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Prather Chad 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reed Kevin 5825 Airline Dr Baton Rouge LA 70805 20 29 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rhodes Kent M. 5825 Airline Dr Baton Rouge LA 70805 20 41 1 >=18 1 2 1 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Riche Kevin 5825 Airline Dr Baton Rouge LA 70805 20 20 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Richey Thomas H. 5825 Airline Dr Baton Rouge LA 70805 20 02 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schellack Jon 5825 Airline Dr Baton Rouge LA 70805 20 2P 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schellack Jon 5825 Airline Dr Baton Rouge LA 70805 20 33 1 none 1 2 1 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schmeeckle Kellie 5825 Airline Dr Baton Rouge LA 70805 20 2H 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Shannon Amie 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sparks Thomas 5825 Airline Dr Baton Rouge LA 70805 20 16 1 >=16 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Spell Derrick 5825 Airline Dr Baton Rouge LA 70805 20 2H 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thibodeaux Robert 5825 Airline Dr Baton Rouge LA 70805 20 41 1 >=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thomas Christopher 5825 Airline Dr Baton Rouge LA 70805 20 20 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thompson Ernest 5825 Airline Dr Baton Rouge LA 70805 20 41 1 >=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thorla Ira 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323LA DERMATOLOGY ASSOCIATES, LLC Thorla, Jr. Ira H. MD 5825 Airline Dr Baton Rouge LA 70805 20 07 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Traxler Jon 5825 Airline Dr Baton Rouge LA 70805 20 04 1 none 1 2 1 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Usher Andrea 5825 Airline Dr Baton Rouge LA 70805 20 16 1 >=16 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Velez-Yanguas Maria 5825 Airline Dr Baton Rouge LA 70805 20 2H 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Velez-Yanguas Maria 5825 Airline Dr Baton Rouge LA 70805 20 37 1 <=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walker Charles 5825 Airline Dr Baton Rouge LA 70805 20 20 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wang Wilson L. 5825 Airline Dr Baton Rouge LA 70805 20 41 1 >=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Werner Sharon 5825 Airline Dr Baton Rouge LA 70805 20 08 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Williams Karen 5825 Airline Dr Baton Rouge LA 70805 20 2I 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allain Brent W. 5825 Airline Highway Baton Rouge LA 70805 20 02 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allain, Jr Brent 5825 Airline Highway Baton Rouge LA 70805 20 02 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allain, Jr. Brent 5825 Airline Highway Baton Rouge LA 70805 20 02 1 none 1 2 1 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dildy Gary A. 5825 Airline Highway Baton Rouge LA 70805 20 16 1 >=16 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Traxler Jon 5825 Airline Highway Baton Rouge LA 70805 20 04 1 none 1 2 1 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cannatella Marla 5825 Airline Hwy Baton Rouge LA 70805 20 41 1 >=18 1 2 2 30503906 91132323


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dejesus Guido 5825 Airline Hwy Baton Rouge LA 70805 20 41 1 >=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dupont Joseph 5825 Airline Hwy Baton Rouge LA 70805 20 02 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Grahm William 5825 Airline Hwy Baton Rouge LA 70805 20 37 1 <=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson Angela C. 5825 Airline Hwy Baton Rouge LA 70805 20 41 1 >=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Karam George 5825 Airline Hwy Baton Rouge LA 70805 20 2I 1 none 1 2 2 30503906 91132323HEALTH CENTERS IN SCHOOLS Luke Leela 5825 Airline Hwy Baton Rouge LA 70805 20 37 1 <=18 1 2 1 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Luke Leelamma 5825 Airline Hwy Baton Rouge LA 70805 20 37 1 <=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Petty Fred 5825 Airline Hwy Baton Rouge LA 70805 20 06 1 none 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wang Wilson L. 5825 Airline Hwy Baton Rouge LA 70805 20 41 1 >=18 1 2 2 30503906 91132323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Patout Charles 1401 N Foster Dr Baton Rouge LA 70806 35 65 1 none 1 2 2 30461485 91139702THE PHYSICIAN'S ALLIANCE CORP (TPAC) Alonso Elizabeth 1401 N Foster Drive Baton Rouge LA 70806 20 37 1 <=18 1 2 2 30461485 91139702THE PHYSICIAN'S ALLIANCE CORP (TPAC) Howe John 1401 N Foster Drive Baton Rouge LA 70806 20 08 1 none 1 2 2 30461485 91139702THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stuart Michael O. 1401 N Foster Drive Stanocola Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30461485 91139702THE PHYSICIAN'S ALLIANCE CORP (TPAC) Toups Patricia A 1401 N Foster Drive Stanocola Baton Rouge LA 70806 20 37 1 <=18 1 2 2 30461485 91139702THE PHYSICIAN'S ALLIANCE CORP (TPAC) Burglass Harry 1401 N Foster St Baton Rouge LA 70806 20 07 1 none 1 2 2 30461485 91139702DERMATOLOGY CLINIC Burglass, Jr. Harry A.. MD 1401 N Foster St Baton Rouge LA 70806 20 07 1 none 1 2 2 30461485 91139702THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jackson Scott 1401 N Foster St Baton Rouge LA 70806 20 07 1 none 1 2 2 30461485 91139702HEALTH CENTERS IN SCHOOLS Armstrong Jada 1401 North Foster Baton Rouge LA 70806 20 30 1 none 1 2 2 30461485 91139702THE PHYSICIAN'S ALLIANCE CORP (TPAC) Armstrong Jada 1401 North Foster Baton Rouge LA 70806 20 37 1 <=18 1 2 2 30461485 91139702THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fechete Marta 1401 North Foster Baton Rouge LA 70806 20 08 1 none 1 2 2 30461485 91139702CAROUSEL MEDICAL EQUIPMENT LL 2138 Wooddale Blvd. Bldg. B, Ste. 13 Baton Rouge LA 70806 40 54 1 none 1 2 2 30468440 91115036CAPITOL CITY FAMILY HEALTH CENTER, INC 3140 Florida Street Baton Rouge LA 70806 72 9L 1 none 1 2 1 30450145 91156294CAPITOL CITY FAMILY HEALTH CENTER, INC Campbell, Jr. Walter MD 3140 Florida Street Baton Rouge LA 70806 20 41 1 >=18 1 2 1 30450145 91156294CAPITOL CITY FAMILY HEALTH CENTER, INC Langie Jaqueline MD 3140 Florida Street Baton Rouge LA 70806 20 08 1 none 1 2 1 30450145 91156294CAPITOL CITY FAMILY HEALTH CENTER, INC Martinez DeLana Ped NP 3140 Florida Street Baton Rouge LA 70806 78 79 1 <=18 1 2 1 30450145 91156294CAPITOL CITY FAMILY HEALTH CENTER, INC Rathbun Katherine MD 3140 Florida Street Baton Rouge LA 70806 20 08 1 none 1 2 2 30450145 91156294CAPITOL CITY FAMILY HEALTH CENTER, INC Robertson-Poitier Lisa NP 3140 Florida Street Baton Rouge LA 70806 78 08 1 none 1 2 1 30450145 91156294CAPITOL CITY FAMILY HEALTH CENTER, INC Webber, Jr. Joseph FNP 3140 Florida Street Baton Rouge LA 70806 78 08 1 none 1 2 1 30450145 91156294BAYOU RADIATION ONCOLOGY 3401 North Blvd Baton Rouge LA 70806 20 2J 1 none 1 2 2 30448371 91154166Primary Care Group Batie Donnie MD 3401 North Blvd Ste 130 Baton Rouge LA 70806 20 08 1 None 2 1 2 30448371 91154166Primary Care Group Jones Stacy D MD 3401 North Blvd Baton Rouge LA 70806 20 08 1 None 2 1 2 30448371 91154166BAYOU RADIATION ONCOLOGY Lauve Andrew D. MD 3401 North Blvd Baton Rouge LA 70806 20 2J 1 none 1 2 2 30448371 91154166THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mayo Tamika 3401 North Blvd Ste 360 Baton Rouge LA 70806 20 08 1 None 1 2 1 30448371 91154166THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mays Spyrie D. 3401 North Blvd Ste 340 Baton Rouge LA 70806 20 34 1 none 1 2 2 30448371 91154166Baton Rouge Neurosurgical Associate Molloy Gerald MD 3401 North Blvd Ste 100 Baton Rouge LA 70806 20 14 1 None 2 1 2 30448371 91154166Njoku Outpatient Clinic Njoku Patrick O MD 3401 North Blvd Ste 325 Baton Rouge LA 70806 20 2I 1 None 2 1 2 30448371 91154166THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nuss Daniel W. 3401 North Blvd Suite 400 Baton Rouge LA 70806 20 2H 1 none 1 2 2 30448371 91154166BAYOU RADIATION ONCOLOGY Russell William E. MD 3401 North Blvd Baton Rouge LA 70806 20 2J 1 none 1 2 2 30448371 91154166First Care Physicians Sheybani Reza MD 3401 North Blvd Ste 320 Baton Rouge LA 70806 20 29 1 None 2 1 2 30448371 91154166Primary Care Group Vinayagam Vasanthi MD 3401 North Blvd Baton Rouge LA 70806 20 08 1 None 2 1 1 30448371 91154166Primary Care Group Wahid Darakhshan MD 3401 North Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 1 30448371 91154166Primary Care Group Wood Robert MD 3401 North Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30448371 91154166Ochsner Clinic Boyer Cynthia I. 3401 North Blvd. Baton Rouge LA 70806 20 2J 1 none 1 2 2 30448371 91154166Ochsner Clinic Cary Susan G. 3401 North Blvd. Baton Rouge LA 70806 78 79 1 >=18 1 2 2 30448371 91154166Ochsner Clinic Tremblay Pam Pyburn 3401 North Blvd. Baton Rouge LA 70806 78 79 1 >=18 1 2 2 30448371 91154166PARISH ANESTHESIA OF BATON ROUGE 3600 FLORIDA BLVD BATON ROUGE LA 70806 20 05 1 none 1 2 2 30450201 91154475Hospital Medicine Group Aaron Rachel MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Hospital Medicine Group Apavaloaie Oana C MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Hospital Medicine Group Atallah Rabih MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Hospital Medicine Group Ausef Amir MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 None 2 1 2 30450201 91154475


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Hospital Medicine Group Banda Venkat R MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 None 2 1 2 30450201 91154475Hospital Medicine Group Bardin Erin B MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 None 2 1 2 30450201 91154475

Baton Rouge General - Mid City 3600 Florida Blvd Baton Rouge LA 70806 60 2E 1 None 2 1 1 30450201 91154475

Baton Rouge General - Mid City 3600 Florida Blvd Baton Rouge LA 70806 60 65 1 None 2 1 1 30450201 91154475

Baton Rouge General - Mid City 3600 Florida Blvd Baton Rouge LA 70806 60 71 1 None 2 1 1 30450201 91154475

Baton Rouge General - Mid City 3600 Florida Blvd Baton Rouge LA 70806 60 86 1 None 2 1 1 30450201 91154475Hospital Medicine Group Beltran Mario MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 None 2 1 2 30450201 91154475Hospital Medicine Group Cassano Ronnie L NP 3600 Florida Blvd Baton Rouge LA 70806 78 87 1 None 2 1 2 30450201 91154475Hospital Medicine Group Chamarthy Srinivasu MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Hospital Medicine Group Colin Elsie M MD 3600 Florida Blvd Baton Rouge LA 70806 20 65 1 None 2 1 2 30450201 91154475Hospital Medicine Group Dobreva-Yakimova Violetta MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gomez Ricardo 3600 Florida Blvd Baton Rouge LA 70806 20 37 1 <=18 1 2 2 30450201 91154475Hospital Medicine Group Gummadi Subhakar MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 None 2 1 2 30450201 91154475Hospital Medicine Group Holder Mark MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Baton Rouge General Orthopedic Assc Hubbard William MD 3600 Florida Blvd Baton Rouge LA 70806 20 20 1 None 2 1 2 30450201 91154475Hospital Medicine Group Kakarala Venu MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 None 2 1 2 30450201 91154475Hospital Medicine Group Kovach Angela D MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Hospital Medicine Group Lodhavia Devang MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475BRG Hospital Specialists Marcelle Dawn MD 3600 Florida Blvd Baton Rouge LA 70806 20 37 1 <=18 2 1 2 30450201 91154475Baton Rouge General Orthopedic Assc Moukarzel Robert MD 3600 Florida Blvd Baton Rouge LA 70806 20 20 1 None 2 1 2 30450201 91154475Hospital Medicine Group Negulescu Catalina MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 None 2 1 2 30450201 91154475THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nunnally Richard 3600 Florida Blvd Baton Rouge LA 70806 20 22 1 none 1 2 2 30450201 91154475Occupational Health Clinic Osterberger James S MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Hospital Medicine Group Pope Karla Rae MD 3600 Florida Blvd Baton Rouge LA 70806 20 08 1 None 2 1 2 30450201 91154475Baton Rouge General Surgical Assoc Puyau Michael MD 3600 Florida Blvd Baton Rouge LA 70806 20 02 1 None 2 1 2 30450201 91154475Baton Rouge General Physicians Hospital Roberts Floyd MD 3600 Florida Blvd Baton Rouge LA 70806 20 29 1 None 2 1 2 30450201 91154475Hospital Medicine Group Shah Manzoor A MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 1 30450201 91154475Hospital Medicine Group Shepherd Kay NP 3600 Florida Blvd Baton Rouge LA 70806 78 87 1 None 2 1 2 30450201 91154475Hospital Medicine Group Smith Christine MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Baton Rouge General Ear Nose and Th Surek Christopher MD 3600 Florida Blvd Baton Rouge LA 70806 20 17 1 None 2 1 2 30450201 91154475Hospital Medicine Group Tati Vasudev H MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Hospital Medicine Group Thigpen Rhonda MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 None 2 1 2 30450201 91154475Occupational Health Clinic Thiruvengadam Arunachalam MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Hospital Medicine Group Vatsavai Raju S MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Occupational Health Clinic Vellanki Vijaya MD 3600 Florida Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30450201 91154475Family Health Center Anderson Derek MD 3801 N Blvd Baton Rouge LA 70806 20 08 1 None 2 1 2 30459859 91121129Family Health Center Chasuk Robert MD 3801 N Blvd Baton Rouge LA 70806 20 08 1 None 2 1 2 30459859 91121129Family Health Center Geno Charles Edward MD 3801 N Blvd Baton Rouge LA 70806 20 08 1 None 2 1 1 30459859 91121129Family Health Center Hill-Spooner Yolonda MD 3801 N Blvd Baton Rouge LA 70806 20 08 1 None 2 1 2 30459859 91121129Family Health Center Schulte Brian S MD 3801 N Blvd Baton Rouge LA 70806 20 08 1 None 2 1 1 30459859 91121129Family Health Center Shaw Vincent MD 3801 N Blvd Baton Rouge LA 70806 20 08 1 None 2 1 2 30459859 91121129

Baton Rouge General - Mid City



Baton Rouge General Medical Center

Br General Medical Ctr


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Banks Raynando 3905 Convention St Baton Rouge LA 70806 20 08 1 None 1 2 1 30449570 91149933Raymando L Banks MD Inc Banks Raynando L MD 3905 Convention St Baton Rouge LA 70806 20 2E 1 >5 1 2 1 30449570 91149933THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jones Stacy 3905 Convention St Baton Rouge LA 70806 20 08 1 None 1 2 1 30449570 91149933DEEKAY MEDICAL CENTER Ibekwe Ruby 3923 Convention Street Baton Rouge LA 70806 20 08 1 None 1 2 1 30449577 91149769LABCORP 3929 CONVENTION STREET BATON ROUGE LA 70806 20 30 1 none 1 1 2 30449580 91149714CHILD HEALTH AMERICA PHYSICIAN GROUP Nguyen Ahn MD 3955 Government St Ste 1 Baton Rouge LA 70806 20 08 1 none 1 2 2 30444439 91149087Child Health America Physician Grp Nguyen Ahn MD 3955 Government St Ste 1 Baton Rouge LA 70806 20 37 1 <=18 2 1 2 30444439 91149087Child Health America Physician Grp Nguyen Xuong H MD 3955 Government St Ste 1 Baton Rouge LA 70806 20 08 1 None 2 1 2 30444439 91149087Louisiana Internal Medicine Assoc Cabiran Peter D MD 4045 N Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30444998 91123860Louisiana Internal Medicine Assoc Campo Nicholas J MD 4045 N Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30444998 91123860Louisiana Internal Medicine Assoc Hargroder James A MD 4045 N Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30444998 91123860Louisiana Internal Medicine Assoc Kahn Jeffrey M MD 4045 N Blvd Baton Rouge LA 70806 20 41 1 >=18 2 1 2 30444998 91123860Louisiana Internal Medicine Assoc Morris Jed L MD 4045 N Blvd Baton Rouge LA 70806 20 2M 1 None 2 1 2 30444998 91123860Louisiana Internal Medicine Assoc Whitty Kristin K NP 4045 N Blvd Baton Rouge LA 70806 78 87 1 None 2 1 2 30444998 91123860THE PHYSICIAN'S ALLIANCE CORP (TPAC) Whitfield Rani 429 East Airport Drive Suite 4 Baton Rouge LA 70806 20 08 1 None 1 2 2 30447291 91102090THE PHYSICIAN'S ALLIANCE CORP (TPAC) Williams Ellis E. 438 Park Hills Drive Baton Rouge LA 70806 20 10 1 none 1 2 2 30451973 91150503THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hymbaugh Michael E. 4550 North Blvd Ste 115 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30448457 91142574ALTERNATIVE FOOT CLINIC 4560 North Blvd Ste 119 Baton Rouge LA 70806 32 48 1 none 1 2 2 30448459 91142496EXCELTH FAMILY HEALTH CENTER 4560 North Blvd Ste 120 Baton Rouge LA 70806 72 9L 1 none 1 2 2 30448459 91142496ALTERNATIVE FOOT CLINIC Davis Alex J. 4560 North Blvd Ste 119 Baton Rouge LA 70806 32 48 1 none 1 2 1 30448459 91142496EXCELTH FAMILY HEALTH CENTER Donaldson-Bailey Michelle D. POD 4560 North Blvd Ste 120 Baton Rouge LA 70806 32 48 1 >=18 1 2 2 30448459 91142496EXCELTH FAMILY HEALTH CENTER Edwards Danielle MD 4560 North Blvd Ste 104 Baton Rouge LA 70806 20 08 1 None 1 2 2 30448459 91142496EXCELTH FAMILY HEALTH CENTER Gonzales Lolita MD 4560 North Blvd Ste 120 Baton Rouge LA 70806 20 37 1 <=18 1 2 2 30448459 91142496EXCELTH FAMILY HEALTH CENTER Imseis Manuel MD 4560 North Blvd Ste 104 Baton Rouge LA 70806 20 37 1 none 1 2 2 30448459 91142496EXCELTH FAMILY HEALTH CENTER Meyn Madelyn MD 4560 North Blvd Ste 120 Baton Rouge LA 70806 20 37 1 <=18 1 2 2 30448459 91142496EXCELTH FAMILY HEALTH CENTER Ogbuefi Chioma MD 4560 North Blvd Ste 104 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30448459 91142496EXCELTH FAMILY HEALTH CENTER Shalaby Mona MD 4560 North Blvd Ste 120 Baton Rouge LA 70806 20 08 1 none 1 2 2 30448459 91142496EXCELTH FAMILY HEALTH CENTER Shalaby Monir MD 4560 North Blvd Ste 104 Baton Rouge LA 70806 20 37 1 none 1 2 2 30448459 91142496EXCELTH FAMILY HEALTH CENTER Winfrey Wylea G. MN, FNP-C 4560 North Blvd Ste 104 Baton Rouge LA 70806 78 08 1 >=18 1 2 2 30448459 91142496DUPONT IRBY P OD Dupont Irby P. OD 4560 North Blvd. Baton Rouge LA 70806 28 88 1 none 1 2 2 30448459 91142496Baton Rouge Eye Physicians Holloway R Ashton MD 4848 N Blvd Baton Rouge LA 70806 20 18 1 None 1 1 1 30435190 91108088Baton Rouge Eye Physicians Oliver Victor M MD 4848 N Blvd Baton Rouge LA 70806 20 18 1 None 1 1 2 30435190 91108088Baton Rouge Eye Physicians Peavy Donald R MD 4848 N Blvd Baton Rouge LA 70806 20 18 1 None 1 1 2 30435190 91108088TUMINELLO OPTICAL 4848 North Boulevard Baton Rouge LA 70806 28 88 1 none 1 2 1 30448523 91140247THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bueche Deborah 503 Colonial Dr Baton Rouge LA 70806 35 65 1 none 1 2 2 30446812 91098381THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fogle Keith 503 Colonial Dr Baton Rouge LA 70806 35 65 1 none 1 2 2 30446812 91098381THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lane Richard 503 Colonial Dr Baton Rouge LA 70806 35 65 1 none 1 2 2 30446812 91098381THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schexnayder Jessica 503 Colonial Dr Baton Rouge LA 70806 35 65 1 none 1 2 2 30446812 91098381THE PHYSICIAN'S ALLIANCE CORP (TPAC) Weger Marcia 503 Colonial Dr Baton Rouge LA 70806 35 65 1 none 1 2 2 30446812 91098381THE PHYSICIAN'S ALLIANCE CORP (TPAC) Robbins Rhett J. 503 Colonial Drive Baton Rouge LA 70806 35 65 1 none 1 2 2 30446812 91098381THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lemoine Lance 530 Shadows Lane Baton Rouge LA 70806 35 65 1 none 1 2 2 30446831 91097528THE PHYSICIAN'S ALLIANCE CORP (TPAC) Voelker Elizabeth 530 Shadows Lane Baton Rouge LA 70806 35 65 1 none 1 2 2 30446831 91097528THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stewart Linda 604 Chevelle Ct, Ste C Baton Rouge LA 70806 20 08 1 None 1 2 2 30445428 91099547THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hall Corey 606 Colonial Drive Baton Rouge LA 70806 20 41 1 >=18 1 2 1 30445235 91098701THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barbier Lacie 6723 Jefferson Hwy Baton Rouge LA 70806 37 74 1 none 1 2 2 30434036 91120593THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brown Angelle 6723 Jefferson Hwy Baton Rouge LA 70806 37 74 1 none 1 2 2 30434036 91120593THE PHYSICIAN'S ALLIANCE CORP (TPAC) Crawford Marieke 6723 Jefferson Hwy Baton Rouge LA 70806 35 65 1 none 1 2 2 30434036 91120593THE PHYSICIAN'S ALLIANCE CORP (TPAC) Culpepper Kristie 6723 Jefferson Hwy Baton Rouge LA 70806 35 65 1 none 1 2 2 30434036 91120593THE PHYSICIAN'S ALLIANCE CORP (TPAC) Groome Andrew 6723 Jefferson Hwy Baton Rouge LA 70806 35 65 1 none 1 2 2 30434036 91120593THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guidry Bobby 6723 Jefferson Hwy Baton Rouge LA 70806 35 65 1 none 1 2 2 30434036 91120593


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Harris Kristie 6723 Jefferson Hwy Baton Rouge LA 70806 35 65 1 none 1 2 2 30434036 91120593THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rogers Ginger 6723 Jefferson Hwy Baton Rouge LA 70806 37 74 1 none 1 2 2 30434036 91120593Yolunda J. Taylor, M.D. Abrams, Jr. Mathew MD 673 East Airport Ave Baton Rouge LA 70806 20 16 1 >=16 1 2 1 30444083 91101961Yolunda J. Taylor, M.D. Henderson Francis H. MD 673 East Airport Ave Baton Rouge LA 70806 20 16 1 >=16 1 2 1 30444083 91101961Yolunda J. Taylor, M.D. Taylor Yolanda J. MD 673 East Airport Ave Baton Rouge LA 70806 20 16 1 >=16 1 2 1 30444083 91101961BATON ROUGE OB/GYN ASSOCIATES Abrams, Jr. Mathew MD 673 East Airport Ave. Baton Rouge LA 70806 20 16 1 >=16 1 2 1 30444083 91101961Gregory M Heroman MD Heroman Gregory M MD 711 Colonial Dr Ste D Baton Rouge LA 70806 20 16 1 >=16 Female 2 1 2 30444294 91099423THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dugas Robert 720 Connells Park Lane Baton Rouge LA 70806 20 20 1 none 1 2 2 30444788 91096279Baton Rouge Sports Medicine Clinic Dugas Robert W MD 720 Connells Park Lane Baton Rouge LA 70806 20 88 1 None 1 2 2 30444788 91096279THE PHYSICIAN'S ALLIANCE CORP (TPAC) Francis Adeboye 7240 Renoir Avenue Baton Rouge LA 70806 20 41 1 >=18 1 2 1 30460714 91116040FERTILE CRESCENT PEDIATRICS Despinasse, II Brian MD 730 Colonial Dr Ste B Baton Rouge LA 70806 20 37 1 <=18 1 2 1 30444079 91099860The Vision Center Carnaggio Carl J OD 7515 Florida Blvd Baton Rouge LA 70806 28 88 1 None 1 2 1 30451938 91110846Ramon A Aizpurua MD Aizpurua Ramon A MD 761 Colonial Dr Baton Rouge LA 70806 20 16 1 >=16 Female 2 1 1 30443500 91099535CARNAGGIO CARL Jr., OD Carnaggio Jr Carl (Joey) OD 7660 Florida Blvd. Baton Rouge LA 70806 28 88 1 none 1 2 1 30451594 91109728Associates in Women's Health 781 Colonial Dr Baton Rouge LA 70806 20 16 1 >=16 1 2 2 30443126 91099520Associates in Women's Health Blanchard Colette 781 Colonial Dr Baton Rouge LA 70806 78 08 1 >=18 1 2 2 30443126 91099520Associates in Women's Health Harris Renee S. 781 Colonial Dr Baton Rouge LA 70806 20 16 1 >=16 1 2 1 30443126 91099520Associates in Women's Health Puyau Susan F. 781 Colonial Dr Baton Rouge LA 70806 20 16 1 >=16 1 2 1 30443126 91099520Associates in Women's Health Thomas Terrie 781 Colonial Dr Baton Rouge LA 70806 20 16 1 >=16 1 2 1 30443126 91099520ACL HEARING & BALANCE CENTER Mesina Cathy MA/CCCA 7952 Goodwood Blvd. Baton Rouge LA 70806 34 64 1 none 1 2 2 30442161 91106153THE PHYSICIAN'S ALLIANCE CORP (TPAC) Goodell Richard 8415 Goodwood Blvd, Ste 105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bonnecaze Andre 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Evangelista-Dean Maria 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Falcon Stephanie 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fee James 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Garbutt Mark 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Giarrusso Amy 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Green Michael 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jackson Jon 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kantrow Mark 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mendoza Jose 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Murphree Paul 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Slataper Richard 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Teague Michael 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vincent Emily 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Westerfield James 8415 Goodwood Blvd., #105 Baton Rouge LA 70806 20 41 1 >=18 1 2 2 30442845 91098110THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcreynolds Robert 8416 Cumberland Pl Baton Rouge LA 70806 20 30 1 none 1 2 1 30444919 91097120DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Collins Ted Z. MD 8416 Cumberland Place Baton Rouge LA 70806 20 30 1 none 1 2 2 30444919 91097120DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Greeson Charles S. MD 8416 Cumberland Place Baton Rouge LA 70806 20 30 1 none 1 2 1 30444919 91097120DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Hook Gina W. MD 8416 Cumberland Place Baton Rouge LA 70806 20 30 1 none 1 2 1 30444919 91097120DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Jones-Braswell Deana A. MD 8416 Cumberland Place Baton Rouge LA 70806 20 30 1 none 1 2 1 30444919 91097120DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Woody Mark W. MD 8416 Cumberland Place Baton Rouge LA 70806 20 30 1 none 1 2 1 30444919 91097120AUDIBEL HEARING HEALTHCARE 8754 Goodwood Blvd Baton Rouge LA 70806 34 64 1 none 1 2 2 30442578 91093096BATON ROUGE PRIMARY CARE COLLABORATIVE 2013 Central Rd Baton Rouge LA 70807 72 9L 1 none 1 2 2 30535076 91171802BATON ROUGE PRIMARY CARE COLLABORATIVE Amacker Shannon 2013 Central Rd Baton Rouge LA 70807 20 08 1 None 1 2 2 30535076 91171802BATON ROUGE PRIMARY CARE COLLABORATIVE Anderson Danita MD 2013 Central Rd Baton Rouge LA 70807 20 08 1 None 1 2 2 30535076 91171802BATON ROUGE PRIMARY CARE COLLABORATIVE Bland Stacie 2013 Central Rd Baton Rouge LA 70807 78 08 1 None 1 2 2 30535076 91171802THE PHYSICIAN'S ALLIANCE CORP (TPAC) Zheng Yihong 2013 Central Road Baton Rouge LA 70807 20 08 1 none 1 2 2 30535076 91171802THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dennis Gary 7855 Howell Blvd Suite 130-b Baton Rouge LA 70807 20 14 1 none 1 2 1 30518632 91155541THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lewis Janet E. 7855 Howell Blvd, Ste 130-b Baton Rouge LA 70807 20 20 1 none 1 2 2 30518632 91155541


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Knatt Theodore 7855 Howell Blvd, Ste 200 Baton Rouge LA 70807 20 20 1 none 1 2 2 30518632 91155541THE PHYSICIAN'S ALLIANCE CORP (TPAC) Peterson Darryl 7855 Howell Blvd, Ste 200 Baton Rouge LA 70807 20 20 1 none 1 2 1 30518632 91155541THE PHYSICIAN'S ALLIANCE CORP (TPAC) Littleton Jeffrey 7855 Howell Blvd, Ste 300 Baton Rouge LA 70807 20 02 1 none 1 2 1 30518632 91155541THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mencer Ernest 7855 Howell Blvd, Ste 300 Baton Rouge LA 70807 20 02 1 none 1 2 1 30518632 91155541Cerebral Palsy Assoc of GBR Barrios Kris L MA-CCC-SLP1805 College Dr Baton Rouge LA 70808 39 71 1 <=18 2 1 2 30432065 91134884Cerebral Palsy Assoc of GBR Fuoto Ellen M MS 1805 College Dr Baton Rouge LA 70808 39 71 1 <=18 2 1 2 30432065 91134884Cerebral Palsy Assoc of GBR Gauthreaux Debra H BS-MS 1805 College Dr Baton Rouge LA 70808 37 74 1 <=18 2 1 2 30432065 91134884Cerebral Palsy Assoc of GBR Haynes Kimberly B MA 1805 College Dr Baton Rouge LA 70808 39 71 1 <=18 2 1 2 30432065 91134884Cerebral Palsy Assoc of GBR Otts Lesley A MS 1805 College Dr Baton Rouge LA 70808 39 71 1 <=18 2 1 2 30432065 91134884Cerebral Palsy Assoc of GBR Thomas Ellen E MA-CCC-SLP1805 College Dr Baton Rouge LA 70808 39 71 1 <=18 2 1 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. 1805 College Drive Baton Rouge LA 70808 35 65 1 <=18 1 2 1 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Barrios Kristin 1805 College Drive Baton Rouge LA 70808 29 71 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Bohan Helen 1805 College Drive Baton Rouge LA 70808 37 74 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Broyles Nancy 1805 College Drive Baton Rouge LA 70808 35 65 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Deaton Ashley 1805 College Drive Baton Rouge LA 70808 35 65 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Gauthreaus Debbie 1805 College Drive Baton Rouge LA 70808 37 74 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Haynes Kimberly 1805 College Drive Baton Rouge LA 70808 29 71 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Hindrichs Anne 1805 College Drive Baton Rouge LA 70808 35 65 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Hoffman Lauren 1805 College Drive Baton Rouge LA 70808 35 65 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Langlois Mandy 1805 College Drive Baton Rouge LA 70808 35 65 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Otts Lesley 1805 College Drive Baton Rouge LA 70808 29 71 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Thomas Ellen 1805 College Drive Baton Rouge LA 70808 29 71 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Trahan Alisa 1805 College Drive Baton Rouge LA 70808 29 71 1 <=18 1 2 2 30432065 91134884CEREBRAL PALSY ASSOCIATION OF GBR, Inc. Weindorf Whitney Jo 1805 College Drive Baton Rouge LA 70808 37 74 1 <=18 1 2 2 30432065 91134884THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith A. Neil 2223 Quail Run Ste D1 Baton Rouge LA 70808 20 13 1 none 1 2 2 30406094 91125999RONALD LANDRY DDS 2726 CONTINENTAL DRIVE BATON ROUGE LA 70808 32 48 1 none 1 1 2 30422064 91136748First Care Physicians at St James Chalasani Lalitha MD 333 Lee Dr Ste B Baton Rouge LA 70808 20 41 1 >=18 2 1 2 30399566 91154770THE PHYSICIAN'S ALLIANCE CORP (TPAC) McClelland Scott 4715 Perkins Road Baton Rouge LA 70808 35 65 1 none 1 2 2 30415656 91140976

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Zeretzke Christina 500 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30402400 91106700THE PHYSICIAN'S ALLIANCE CORP (TPAC) Turner Christopher 5000 Hennesey Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wagstaff Daniel 5000 Hennesey Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wagstaff Rebecca 5000 Hennesey Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Awotwi Joseph 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Borne Glenn 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boudreaux Shannon 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bryant Sarah 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Choojtarom Thiravat 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

Pediatric Specialty Clinic







LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Deschutter Mathieu 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Deyo Sarah PA-C 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fontenot Angela APRN 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Frierson Michael 5000 Hennessey Blvd Baton Rouge LA 70808 20 20 1 none 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Funes Christopher 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Giorlando Paul 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gouri Brian G 5000 Hennessey Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hasan Irfan 5000 Hennessey Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hutchinson Brett 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lasseigne, Jr Richard 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lo Catherine 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lucas Ashley 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Monroe, Fnp-c Latonya Fnp-c 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moore Shelia 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Narang Anuj 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Parent, Pa-c Kristy 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Randall, Fnp-c Zelma 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rao Murli 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400


















LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Raven Mary 5000 Hennessey Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rodrigue Brad 5000 Hennessey Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ross Jr Sidney 5000 Hennessey Blvd Trauma Specialists Baton Rouge LA 70808 20 02 1 none 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Saucier Ashley 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stout Brian 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Templet Jessica PA 5000 Hennessey Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Alberty John 5000 Hennessey Blvd Ste 502 Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barua Urvashi 5000 Hennessey Blvd Ste 502 Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wascome Eric J 5000 Hennessey Nlvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30406531 91133122PEDIATRIC CARDIOLOGY ASSOCIATES 5000 Hennessy Blvd Baton Rouge LA 70808 20 1D 1 none 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Blaize, III Leo 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400PEDIATRIC CARDIOLOGY ASSOCIATES Brumund Michael R. MD 5000 Hennessy Blvd Baton Rouge LA 70808 20 1D 1 none 1 2 1 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Causey Robert 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cayton Stewart 5000 Hennessy Blvd Trauma Specialists Baton Rouge LA 70808 20 02 1 none 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chadha Sandeep 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chamberlain Matthew 5000 Hennessy Blvd Baton Rouge LA 70808 20 08 1 none 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chamberlain Matthew 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400PEDIATRIC CARDIOLOGY ASSOCIATES Crapanzano Michael S. MD 5000 Hennessy Blvd Baton Rouge LA 70808 20 1D 1 none 1 2 1 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fahr Michael 5000 Hennessy Blvd Trauma Specialists Baton Rouge LA 70808 20 02 1 none 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Golden Barbara J. 5000 Hennessy Blvd Baton Rouge LA 70808 20 13 1 none 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Golden Barbara 5000 Hennessy Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gremillion Brian 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Halliburton Charles 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hannegan Jason 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400PEDIATRIC CARDIOLOGY ASSOCIATES Hixon Rufus L. MD 5000 Hennessy Blvd Baton Rouge LA 70808 20 1D 1 none 1 2 1 30401800 91105400

WOMANS HOSPITAL FOUNDATION Hollman Charlotte MD 5000 Hennessy Blvd Baton Rouge LA 70808 20 13 1 none 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hollman Charlotte 5000 Hennessy Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jacome Tomas 5000 Hennessy Blvd Trauma Specialists Baton Rouge LA 70808 20 02 1 none 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 5000 Hennessy Blvd Baton Rouge LA 70808 20 03 1 none 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 5000 Hennessy Blvd Baton Rouge LA 70808 20 08 1 none 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Malmstrom Kenneth 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400











LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mccormick Theron 5000 Hennessy Blvd Baton Rouge LA 70808 20 03 1 none 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mccormick Theron 5000 Hennessy Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meek Brad 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nguyen Vinh 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Norwood Scott 5000 Hennessy Blvd Trauma Specialists Baton Rouge LA 70808 20 02 1 none 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reyes Efrain P. 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400

WOMANS HOSPITAL FOUNDATION Schexnayder Lalania MD 5000 Hennessy Blvd Baton Rouge LA 70808 20 13 1 none 1 2 2 30401800 91105400

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schexnayder Lalania 5000 Hennessy Blvd Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Streetman William 5000 Hennessy Blvd Trauma Specialists Baton Rouge LA 70808 20 02 1 none 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stuke Lance 5000 Hennessy Blvd Trauma Specialists Baton Rouge LA 70808 20 02 1 none 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wood Carter 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Belleau Christopher 5000 Hennessy Blvd, Rehab Baton Rouge LA 70808 35 65 1 none 1 2 2 30401202 91133035THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fisher Lawrence S 5000 Hennessy Blvd, Rehab Baton Rouge LA 70808 78 79 1 >=18 1 2 2 30401202 91133035THE PHYSICIAN'S ALLIANCE CORP (TPAC) Beeharilal Permanand 5000 Hennessy Blvd. Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Basireddy Mahesh R 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Corona Raynold 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dornier Matthew NP 5131 Odonovan First Floor Baton Rouge LA 70808 78 79 1 >=18 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Groeger Catherine 5131 Odonovan First Floor Baton Rouge LA 70808 78 79 1 >=18 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hebert Mitchell 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Humbles Kirby 5131 Odonovan First Floor Baton Rouge LA 70808 78 79 1 >=18 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kenney Robert 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Landry Robert 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Luscy Christopher 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Marsh Daniel 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 1 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Murrill William B. 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Roppolo Michael 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 1 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Samuel Jones 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith Kenneth G. 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 2 30404289 91112301THE PHYSICIAN'S ALLIANCE CORP (TPAC) Yegge James 5131 Odonovan First Floor Baton Rouge LA 70808 20 2K 1 none 1 2 1 30404289 91112301CALAIS DERMATOLOGY ASSOCIATES Brantley John B. MD 5220 Flanders Drive Baton Rouge LA 70808 20 07 1 none 1 2 2 30401294 91107785CALAIS DERMATOLOGY ASSOCIATES McEwen Christopher J. MD 5220 Flanders Drive Baton Rouge LA 70808 20 07 1 none 1 2 2 30401294 91107785CALAIS DERMATOLOGY ASSOCIATES Patterson Connor MD 5220 Flanders Drive Baton Rouge LA 70808 20 07 1 none 1 2 2 30401294 91107785THE PHYSICIAN'S ALLIANCE CORP (TPAC) Breaux Darrin 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cefalu Joseph 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844THE PHYSICIAN'S ALLIANCE CORP (TPAC) Clausen Harold 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fontenot Daniel 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844THE PHYSICIAN'S ALLIANCE CORP (TPAC) Helm Boyd E. 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kilpatrick Kevin 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844THE PHYSICIAN'S ALLIANCE CORP (TPAC) Patrick Henry 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844THE PHYSICIAN'S ALLIANCE CORP (TPAC) Petty Fred 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rodney Evens 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 1 30401722 91108844THE PHYSICIAN'S ALLIANCE CORP (TPAC) Surakanti Venkat 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844






LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Swirsky Brian 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844THE PHYSICIAN'S ALLIANCE CORP (TPAC) Zellmer Terry 5231 Brittany Drive Baton Rouge LA 70808 20 06 1 none 1 2 2 30401722 91108844ENT MEDICAL CENTER Boone Ryan T. MD 5258 Dijon Drive Baton Rouge LA 70808 20 04 1 none 1 2 1 30402887 91111787ENT MEDICAL CENTER Hall Christian A. MD 5258 Dijon Drive Baton Rouge LA 70808 20 04 1 none 1 2 1 30402887 91111787ENT MEDICAL CENTER Kobe Casie C. MCD 5258 Dijon Drive Baton Rouge LA 70808 34 64 1 none 1 2 2 30402887 91111787ENT MEDICAL CENTER LeBlanc Charles A. MD 5258 Dijon Drive Baton Rouge LA 70808 20 04 1 none 1 2 2 30402887 91111787ENT MEDICAL CENTER Mitchell Charles F. MD 5258 Dijon Drive Baton Rouge LA 70808 20 04 1 none 1 2 2 30402887 91111787ENT MEDICAL CENTER Ringe Misty N. AUD 5258 Dijon Drive Baton Rouge LA 70808 34 64 1 none 1 2 2 30402887 91111787THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wolfsheimer Frank 5305 Flanders Dr Baton Rouge LA 70808 20 10 1 none 1 2 2 30400505 91107909THE PHYSICIAN'S ALLIANCE CORP (TPAC) Faruqui Shaista 5320 Dijon Ave Baton Rouge LA 70808 20 2H 1 none 1 2 2 30402436 91112063DERMATOLOGY CLINIC Burglass, Jr. Harry A.. MD 5326 O'Donovan Drive Baton Rouge LA 70808 20 07 1 none 1 2 2 30402906 91113562DERMATOLOGY CLINIC Byrd Lori N. MD 5326 O'Donovan Drive Baton Rouge LA 70808 20 07 1 none 1 2 2 30402906 91113562DERMATOLOGY CLINIC Dobson Mary M. MD 5326 O'Donovan Drive Baton Rouge LA 70808 20 07 1 none 1 2 2 30402906 91113562DERMATOLOGY CLINIC Massengale William T. MD 5326 O'Donovan Drive Baton Rouge LA 70808 20 07 1 none 1 2 2 30402906 91113562DERMATOLOGY CLINIC Meek, Jr. Tom J. MD 5326 O'Donovan Drive Baton Rouge LA 70808 20 07 1 none 1 2 2 30402906 91113562DERMATOLOGY CLINIC Poche George W. MD 5326 O'Donovan Drive Baton Rouge LA 70808 20 07 1 none 1 2 2 30402906 91113562DERMATOLOGY CLINIC Shannon Amie B. 5326 O'Donovan Drive Baton Rouge LA 70808 20 07 1 none 1 2 2 30402906 91113562THE PHYSICIAN'S ALLIANCE CORP (TPAC) Baig Mohammed 5339 Didesse Dr Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401590 91110609THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barfield Lauren 5339 Didesse Dr Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401590 91110609THE PHYSICIAN'S ALLIANCE CORP (TPAC) Davis Tiffany 5339 Didesse Dr Baton Rouge LA 70808 20 08 1 none 1 2 2 30401590 91110609THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gahan W. Patrick 5339 Didesse Dr Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401590 91110609THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nelson Susan 5339 Didesse Dr Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401590 91110609THE PHYSICIAN'S ALLIANCE CORP (TPAC) Adair Jefferey 5408 Flanders Drive Baton Rouge LA 70808 20 05 1 none 1 2 2 30399837 91108682THE PHYSICIAN'S ALLIANCE CORP (TPAC) Braswell John A. 5408 Flanders Drive Baton Rouge LA 70808 20 05 1 none 1 2 2 30399837 91108682THE PHYSICIAN'S ALLIANCE CORP (TPAC) Burdine John 5408 Flanders Drive Baton Rouge LA 70808 20 05 1 none 1 2 2 30399837 91108682THE PHYSICIAN'S ALLIANCE CORP (TPAC) Graham Sean 5408 Flanders Drive Baton Rouge LA 70808 20 05 1 none 1 2 2 30399837 91108682THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ioppolo Anthony 5408 Flanders Drive Baton Rouge LA 70808 20 14 1 none 1 2 2 30399837 91108682THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jiha J. George 5408 Flanders Drive Baton Rouge LA 70808 20 05 1 none 1 2 2 30399837 91108682THE PHYSICIAN'S ALLIANCE CORP (TPAC) Turnipseed Joseph 5408 Flanders Drive Baton Rouge LA 70808 20 05 1 none 1 2 2 30399837 91108682THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kaplan Seth 5414 Brittany Dr Ste G Baton Rouge LA 70808 35 65 1 none 1 2 2 30400483 91109978THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lafauci Tyler 5414 Brittany Dr Ste G Baton Rouge LA 70808 35 65 1 none 1 2 2 30400483 91109978THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leblanc Greg 5414 Brittany Dr Ste G Baton Rouge LA 70808 35 65 1 none 1 2 2 30400483 91109978THE PHYSICIAN'S ALLIANCE CORP (TPAC) Weber Tom 5414 Brittany Dr Ste G Baton Rouge LA 70808 35 65 1 none 1 2 2 30400483 91109978THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sparks John 5422 Dijon Dr Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) De La Bretonne Jacques A. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 2 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Demars Thomas A. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Demouy Jeffrey A. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fa-kouri Michael W. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 2 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fletcher James D. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Foreman Julian B. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gregoire William 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hanson Richard D. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Harris John P. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hoff David J. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Miller Robert W. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nussbaumer, III David P. 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith R. Michael 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 2 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tsai Sang-ting 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wen Clement C 5422 Dijon Drive Baton Rouge LA 70808 20 30 1 none 1 2 1 30401710 91112512THE PHYSICIAN'S ALLIANCE CORP (TPAC) Perkowski Paul 5425 Brittany Dr, Ste B Baton Rouge LA 70808 20 33 1 none 1 2 1 30400270 91109750


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schellack Jon 5425 Brittany Dr, Ste B Baton Rouge LA 70808 20 33 1 none 1 2 1 30400270 91109750THE PHYSICIAN'S ALLIANCE CORP (TPAC) Decuir Anthony 5428 O Donovan Drive Suite C Baton Rouge LA 70808 32 48 1 none 1 2 2 30402131 91114121THE PHYSICIAN'S ALLIANCE CORP (TPAC) Le Qui 5428 O Donovan Drive Suite C Baton Rouge LA 70808 32 48 1 none 1 2 2 30402131 91114121THE PHYSICIAN'S ALLIANCE CORP (TPAC) Savard Maxime 5428 O Donovan Drive Suite C Baton Rouge LA 70808 32 48 1 none 1 2 2 30402131 91114121THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vo Phu 5428 O Donovan Drive Suite C Baton Rouge LA 70808 32 48 1 none 1 2 2 30402131 91114121THE PHYSICIAN'S ALLIANCE CORP (TPAC) Decuir Anthony 5428 O Donovan Drive, Suite C Baton Rouge LA 70808 32 48 1 none 1 2 2 30402131 91114121THE PHYSICIAN'S ALLIANCE CORP (TPAC) Le Qui T. 5428 O Donovan Drive, Suite C Baton Rouge LA 70808 32 48 1 none 1 2 2 30402131 91114121THE PHYSICIAN'S ALLIANCE CORP (TPAC) Savard Maxime 5428 O Donovan Drive, Suite C Baton Rouge LA 70808 32 48 1 none 1 2 2 30402131 91114121THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vo Phu 5428 O Donovan Drive, Suite C Baton Rouge LA 70808 32 48 1 none 1 2 2 30402131 91114121THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ward Gregory 5438 O Donovan Drive Suite 200 Baton Rouge LA 70808 35 65 1 none 1 2 1 30402054 91114173THE PHYSICIAN'S ALLIANCE CORP (TPAC) Faruqui Shaban 6615 Perkins Road Baton Rouge LA 70808 20 10 1 none 1 2 1 30403228 91120741DAVID A DEPP, MD Depp David A. MD 6735 Pikes Lane Baton Rouge LA 70808 20 33 1 >=18 1 2 2 30403362 91115164

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Creekmore Tina 7301 Hennessey Blvd, Ste 200 Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Belleau Christopher 7301 Hennessy Blvd Suite 200 Baton Rouge LA 70808 35 65 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hall Otto C. 7301 Hennessy Blvd Suite 200 Baton Rouge LA 70808 32 48 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hall Patrick 7301 Hennessy Blvd Suite 200 Baton Rouge LA 70808 32 48 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Warner Meredith A. 7301 Hennessy Blvd Suite 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Broyles Joseph 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Frierson Michael 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 1 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hagemann William 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mccarthy Kevin 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Messina Lawrence 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morgan Joe 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Murtagh Gerard 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pope David 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schroeder Alan 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walker Charles 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wilson Stephen 7301 Hennessy Blvd, Ste 200 Baton Rouge LA 70808 20 20 1 none 1 2 2 30404884 91111925ADVANCED SURGICAL CARE OF BAT 7310 Perkins Road Baton Rouge LA 70808 54 86 1 none 1 2 1 30396947 91112873LA CENTER FOR ORTHOPAEDIC & SPORTS MEDICINE Loupe John F. MD 7414 Picardy Ave Ste A Baton Rouge LA 70808 20 20 1 none 1 2 1 30400385 91111848JACQUELINE WILLIAMS Williams Jaqueline G. MD 7516 Picardy Ave., Ste. B Baton Rouge LA 70808 20 37 1 <=18 1 2 1 30400356 91111793THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bhushan Rajat 7566 Picardy Ave Baton Rouge LA 70808 20 2E 1 none 1 2 2 30399902 91111002Proactive Medical The Vascular Lab 7648 Picardy Ave Ste 100 Baton Rouge LA 70808 23 30 1 None 2 1 2 30398739 91109017THE PHYSICIAN'S ALLIANCE CORP (TPAC) 7777 Hennessey Blvd Ste 215 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Adams Courtney A CCC-A 7777 Hennessey Blvd Suite 409 Baton Rouge LA 70808 34 64 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Arriaga Moises 7777 Hennessey Blvd Suite 409 Baton Rouge LA 70808 20 04 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chiasson Edward 7777 Hennessey Blvd Suite 612 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dileo Michael 7777 Hennessey Blvd Suite 409 Baton Rouge LA 70808 20 04 1 none 1 2 2 30402463 91106710FOURRIER DAVID GMD Fourrier David MD 7777 Hennessey Blvd Ste 407 Baton Rouge LA 70808 20 04 1 none 1 2 1 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gordon Stephen 7777 Hennessey Blvd Suite 5004 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kisner Jr Wendell 7777 Hennessey Blvd #5001 Baton Rouge LA 70808 20 05 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lin James 7777 Hennessey Blvd Suite 709 Baton Rouge LA 70808 20 04 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mani Sandhya 7777 Hennessey Blvd Suite 502 Baton Rouge LA 70808 20 03 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mccormick Theron 7777 Hennessey Blvd Ste 5007 Baton Rouge LA 70808 20 03 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mccormick Theron 7777 Hennessey Blvd Ste 5007 Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mclaughlin Kevin E. 7777 Hennessey Blvd Suite 409 Baton Rouge LA 70808 20 04 1 none 1 2 1 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcwhorter Andrew 7777 Hennessey Blvd Ste 408 Baton Rouge LA 70808 20 04 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Montgomery, Ma Elizabeth 7777 Hennessey Blvd Suite 409 Baton Rouge LA 70808 34 64 1 none 1 2 2 30402463 91106710



LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nuss Daniel W 7777 Hennessey Blvd Suite 409 Baton Rouge LA 70808 20 04 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nuss Daniel W. 7777 Hennessey Blvd Suite 409 Baton Rouge LA 70808 20 2H 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pou Anna 7777 Hennessey Blvd Suite 409 Baton Rouge LA 70808 20 04 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) St. John Patti AUD 7777 Hennessey Blvd Suite 409 Baton Rouge LA 70808 34 64 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jhunjhunwala Jay P. 7777 Hennessey Blvd Ste 206 Baton Rouge LA 70808 20 10 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Abuazza Ghazala 7777 Hennessey Blvd Ste 502 Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Deyo Jeffrey 7777 Hennessey Blvd Ste 502 Baton Rouge LA 70808 20 37 1 <=18 1 2 2 30402463 91106710PEDIATRIC CARDIOLOGY ASSOCIATES 7777 Hennessy Blvd Ste 103 Baton Rouge LA 70808 20 1D 1 none 1 2 2 30402463 91106710Eye Medical Center Abbott Michael D OD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 28 88 1 None 1 2 2 30402463 91106710Eye Medical Center Afeman Charles E MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 >=7 2 1 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allain Jr Brent 7777 Hennessy Blvd Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Annaloro Angelo 7777 Hennessy Blvd Suite 2004 Baton Rouge LA 70808 20 34 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bagwell Cherie 7777 Hennessy Blvd Baton Rouge LA 70808 78 08 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Benjamin, III Louis C 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bennett Mary 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Berry Buford 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boedefeld Robyn 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boedefeld William 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bringaze Walter 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710PEDIATRIC CARDIOLOGY ASSOCIATES Brumund Michael R. MD 7777 Hennessy Blvd Ste 103 Baton Rouge LA 70808 20 1D 1 none 1 2 1 30402463 91106710BURNS GERALD F MD Burns Gerald F. MD 7777 Hennessy Blvd Ste 306 Bldg 1 Baton Rouge LA 70808 35 65 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Carter Patrice 7777 Hennessy Blvd Suite 612 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Civello Kenneth 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710Eye Medical Center Collins Candace C MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 <=18 2 1 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Conners Michael 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710Retina & Vitreous of LA Couvillion John T MD 7777 Hennessy Blvd Ste 501 Baton Rouge LA 70808 20 2P 1 None 2 1 2 30402463 91106710PEDIATRIC CARDIOLOGY ASSOCIATES Crapanzano Michael S. MD 7777 Hennessy Blvd Ste 103 Baton Rouge LA 70808 20 1D 1 none 1 2 1 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Craven James E. 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Culotta Roy 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Davis, Jr. Paul M 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Deumite Norman 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Duke Kelly 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710Eye Medical Center Ehrlich Philip D MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 None 2 1 2 30402463 91106710Eye Medical Center Fargason Crayton A MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 >=12 2 1 2 30402463 91106710Eye Medical Center Fargason David P MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 None 2 1 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fields Ronald 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Finan Kelly 7777 Hennessy Blvd Trauma Specialists Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710Eye Medical Center Fivgas George MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 None 2 1 2 30402463 91106710David G Fourrier MD Fourrier David G MD 7777 Hennessy Blvd Ste 407 Baton Rouge LA 70808 20 17 1 None 1 2 1 30402463 91106710Retina & Vitreous of LA Fuller Jeffrey J MD 7777 Hennessy Blvd Ste 501 Baton Rouge LA 70808 20 2P 1 None 2 1 2 30402463 91106710



Suite 612trauma Specialists

Medical Plaza 1 Suite 701





LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Garrett Paul 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710Eye Medical Center Geier Robert OD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 28 88 1 None 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gremillion Steven 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710Eye Medical Center Haik Hilliard M MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 None 2 1 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hathorn Bryan 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hausmann Mark G. 7777 Hennessy Blvd Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Haygood Bolling 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hebert Cullen 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710Eye Medical Center Heigle Thomas J MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 None 2 1 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Helmke Harold 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710PEDIATRIC CARDIOLOGY ASSOCIATES Hixon Rufus L. MD 7777 Hennessy Blvd Ste 103 Baton Rouge LA 70808 20 1D 1 none 1 2 1 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hyde Jeffery 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jagneaux Tonja 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kaplan Jonathan 7777 Hennessy Blvd Ste 702 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kearley Richard 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kleinpeter Kenneth 7777 Hennessy Blvd Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Labatut Dwayne 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Labatut Dwayne 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 78 79 1 >=18 1 2 2 30402463 91106710Eye Medical Center Lamendola Joseph A OD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 28 88 1 None 1 2 2 30402463 91106710Eye Medical Center LaMonica Glen A OD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 28 88 1 None 1 2 1 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Landry Scott 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leblanc Karl 7777 Hennessy Blvd Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710Eye Medical Center Luckett Suzanne S MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 None 2 1 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Luikart Carl 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcclelland John 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mclachlan John 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcneil James 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Merrell John 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moonan Jeffrey 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moraes Denzil 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morris James 7777 Hennessy Blvd Suite 2004 Baton Rouge LA 70808 20 34 1 none 1 2 1 30402463 91106710Eye Medical Center Patin Robert L OD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 28 88 1 None 1 2 2 30402463 91106710Eye Medical Center Pearce Allen R MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 None 2 1 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pearson, Jr. Charles 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pirzadah Mohammad 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Posner Mark 7777 Hennessy Blvd Suite 2004 Baton Rouge LA 70808 20 34 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rees Andrew 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710


Medical Plaza 1, Suite 701

Medical Plaza 1Suite 701









LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rehn Terry 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rhynes Vernon K. 7777 Hennessy Blvd Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rigby Carl 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rogers John NP 7777 Hennessy Blvd Baton Rouge LA 70808 78 08 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sheely Carlton H 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smith Charles 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Speyrer Mary 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Speyrer Mary 7777 Hennessy Blvd Suite 1000 Baton Rouge LA 70808 78 79 1 >=18 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Superneau Duane 7777 Hennessy Blvd Baton Rouge LA 70808 20 22 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thurston Robert 7777 Hennessy Blvd Suite 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Toups Kimberly D. 7777 Hennessy Blvd Baton Rouge LA 70808 78 79 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vick Stephen 7777 Hennessy Blvd Suite 2004 Baton Rouge LA 70808 20 34 1 none 1 2 1 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vincent Brad 7777 Hennessy Blvd Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Whitaker John 7777 Hennessy Blvd Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wills Thomas 7777 Hennessy Blvd Suite 2004 Baton Rouge LA 70808 20 34 1 none 1 2 2 30402463 91106710Eye Medical Center Woo Fay MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 None 2 1 2 30402463 91106710Eye Medical Center Wood Jeremy MD 7777 Hennessy Blvd Ste 4000 Baton Rouge LA 70808 20 18 1 None 2 1 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) 7777 Hennessy Blvd Ste 1008 Baton Rouge LA 70808 20 33 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barfield Louis 7777 Hennessy Blvd Ste 206 Baton Rouge LA 70808 20 10 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Blaize, III Leo 7777 Hennessy Blvd Ste 7000 Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Falgoust Gerard 7777 Hennessy Blvd Ste 7000 Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gremillion Brian 7777 Hennessy Blvd Ste 7000 Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Halliburton Charles 7777 Hennessy Blvd Ste 7000 Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson Jeri 7777 Hennessy Blvd Ste 7000 Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meek Bradley 7777 Hennessy Blvd Ste 7000 Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pearce Katherine 7777 Hennessy Blvd Ste 7000 Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reyes Efrain 7777 Hennessy Blvd Ste 7000 Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Byrd Richard L. 7777 Hennessy Blvd Ste 706 Baton Rouge LA 70808 20 10 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thomas David 7777 Hennessy Blvd, Ste 406 Baton Rouge LA 70808 20 29 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Allain, Jr. Brent 7777 Hennessy Blvd, Ste 612 Baton Rouge LA 70808 20 02 1 none 1 2 1 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hausmann Mark G. 7777 Hennessy Blvd, Ste 612 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kleinpeter Kenneth 7777 Hennessy Blvd, Ste 612 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leblanc Karl 7777 Hennessy Blvd, Ste 612 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rhynes Vernon K. 7777 Hennessy Blvd, Ste 612 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Green Garland 7777 Hennessy Blvd, Suite 8000 Medical Plaza 2 Baton Rouge LA 70808 20 06 1 none 1 2 1 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kelley Steven 7777 Hennessy Blvd, Suite 8000 Medical Plaza 2 Baton Rouge LA 70808 20 06 1 none 1 2 1 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kraft Leon 7777 Hennessy Blvd, Suite 8000 Medical Plaza 2 Baton Rouge LA 70808 20 06 1 none 1 2 1 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lamotte Lance 7777 Hennessy Blvd, Suite 8000 Medical Plaza 2 Baton Rouge LA 70808 20 06 1 none 1 2 1 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Newsome Nakia 7777 Hennessy Blvd, Suite 8000 Medical Plaza 2 Baton Rouge LA 70808 20 06 1 none 1 2 2 30402463 91106710STEPHEN V GORDON, MD Gordon Stephen V. MD 7777 Hennessy Blvd. Suite 702 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710ALEC HIRSCH MD FACS LLC Hirsch Alec MD 7777 Hennessy Blvd. Suite 702 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710BRIDGES CHARLIE H. MD Bridges Charlie H. MD 7777 Hennessy Blvd. Ste 608 Baton Rouge LA 70808 20 34 1 none 1 2 2 30402463 91106710








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WOMANS HOSPITAL FOUNDATION Hirsch Alec MD 7777 Hennessy Blvd., Ste. 702 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710WOMANS HOSPITAL FOUNDATION Puyau Michael MD 7777 Hennessy Blvd., Ste. 702 Baton Rouge LA 70808 20 02 1 none 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nguyen Nhung 7777 Hennessy, Suite 5007 Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30402463 91106710THE PHYSICIAN'S ALLIANCE CORP (TPAC) Movva Padma T 8415 Goodwood Blvd., Ste 105 5000 Hennessy Blvd. Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pham Lan 8415 Goodwood Blvd., Suite 105 5000 Hennessy Blvd Baton Rouge LA 70808 20 41 1 >=18 1 2 2 30401800 91105400LA DERMATOLOGY ASSOCIATES, LLC Dickerson Mary C. MD 10154 Jefferson Hwy. Baton Rouge LA 70809 20 07 1 none 1 2 2 30409347 91070276LA DERMATOLOGY ASSOCIATES, LLC Johnson, Jr. Franklin R. MD 10154 Jefferson Hwy. Baton Rouge LA 70809 20 07 1 none 1 2 2 30409347 91070276LA DERMATOLOGY ASSOCIATES, LLC LeBlanc Jennifer H. 10154 Jefferson Hwy. Baton Rouge LA 70809 78 79 1 >=18 1 2 2 30409347 91070276LA DERMATOLOGY ASSOCIATES, LLC Thorla, Jr. Ira H. MD 10154 Jefferson Hwy. Baton Rouge LA 70809 20 07 1 none 1 2 2 30409347 91070276LABCORP 11441 INDUSTRIPLEX BLVD STE 140 BATON ROUGE LA 70809 20 30 1 none 1 1 2 30387851 91054036LAGNIAPPE MEDICAL EQUIPMENT SALES 11821 Dunlay Lane Baton Rouge LA 70809 40 54 1 none 1 2 2 30383010 91050303LINCARE INC 11931 Industriplex Blvd Ste 500 Baton Rouge LA 70809 20 29 1 none 1 2 1 30384699 91048669LINCARE INC DBA PS HOMECA 11931 INDUSTRIPLEX BLVD SUITE 500 BATON ROUGE LA 70809 40 54 1 none 1 1 2 30384699 91048669ZETA HOME HEALTH CARE 11944 Cloverland Ct. Baton Rouge LA 70809 40 54 1 none 1 2 2 30388799 91048142Apria Healthcare, Inc. 12123 Industriplex Blvd Baton Rouge LA 70809 40 54 1 none 1 1 2 30383880 91045727NATIONAL SEATING & MOBILITY 12232 Industriplax Blvd Ste 17 Baton Rouge LA 70809 40 54 1 none 1 2 2 30383668 91043802THE PHYSICIAN'S ALLIANCE CORP (TPAC) Duplechain Michael 18169 E Petroleum Dr Bldg 9 Baton Rouge LA 70809 20 08 1 none 1 2 2 30351568 91020762THE PHYSICIAN'S ALLIANCE CORP (TPAC) Montelaro Mitchell T 18169 E Petroleum Drive Bldg 9 Baton Rouge LA 70809 20 08 1 none 1 2 2 30351568 91020762THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 3333 Drusilla Lane Lake After Hours Baton Rouge LA 70809 20 03 1 none 1 2 2 30419971 91088145THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 3333 Drusilla Lane Lake After Hours Baton Rouge LA 70809 20 08 1 none 1 2 2 30419971 91088145THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 3333 Drusilla Lane Lake After Hours Baton Rouge LA 70809 20 41 1 >=18 1 2 2 30419971 91088145THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barrow Gray W. 4545 Blubonnett Blvd Baton Rouge LA 70809 35 65 1 none 1 2 2 30407974 91079738THE PHYSICIAN'S ALLIANCE CORP (TPAC) Clark John 4545 Bluebonnet Blvd Baton Rouge LA 70809 35 65 1 none 1 2 2 30407974 91079738THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ellis Walter W. 4545 Bluebonnet Blvd Baton Rouge LA 70809 35 65 1 none 1 2 2 30407974 91079738BLUEBONNET IMAGING CENTER 4570 Bluebonnet Blvd. Suite B Baton Rouge LA 70809 20 30 1 none 1 2 2 30407831 91080327DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Collins Ted Z. MD 4570 Bluebonnet Blvd., #B Baton Rouge LA 70809 20 30 1 none 1 2 2 30407831 91080327DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Greeson Charles S. MD 4570 Bluebonnet Blvd., #B Baton Rouge LA 70809 20 30 1 none 1 2 1 30407831 91080327DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Hook Gina W. MD 4570 Bluebonnet Blvd., #B Baton Rouge LA 70809 20 30 1 none 1 2 1 30407831 91080327DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Jones-Braswell Deana A. MD 4570 Bluebonnet Blvd., #B Baton Rouge LA 70809 20 30 1 none 1 2 1 30407831 91080327DIAGNOSTIC RADIOLOGY CONSULTANTS, LLP Woody Mark W. MD 4570 Bluebonnet Blvd., #B Baton Rouge LA 70809 20 30 1 none 1 2 1 30407831 91080327THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tullier Joseph K. 4860 Bluebonnet Blvd Baton Rouge LA 70809 32 48 1 none 1 2 2 30404346 91081952Foot Clinic of Baton Rouge Tullier Joseph Kemp DPM 4860 Bluebonnet Blvd Baton Rouge LA 70809 32 48 1 None 2 1 2 30404346 91081952LA HEMATOLOGY ONCOLOGY ASSOCIATES 4950 Essen Lane Ste 500 Baton Rouge LA 70809 20 2H 1 >=18 1 2 1 30403178 91104720MARY BIRD PERKINS CANCER CTR Bermudez Richard Scott 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 >=18 1 2 2 30403178 91104720LA HEMATOLOGY ONCOLOGY ASSOCIATES Bienvenu Bryan J. 4950 Essen Lane Ste 500 Baton Rouge LA 70809 20 2H 1 >=18 1 2 2 30403178 91104720THE PHYSICIAN'S ALLIANCE CORP (TPAC) Billings Frederic 4950 Essen Lane Baton Rouge LA 70809 20 2H 1 none 1 2 2 30403178 91104720LA HEMATOLOGY ONCOLOGY ASSOCIATES Billings, III Frederic T. 4950 Essen Lane Ste 500 Baton Rouge LA 70809 20 2H 1 >=18 1 2 2 30403178 91104720Ochsner Clinic Boyer Cynthia I. 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 none 1 2 2 30403178 91104720MARY BIRD PERKINS CANCER CTR Fields Robert S. 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 >=18 1 2 2 30403178 91104720THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hanson David 4950 Essen Lane Baton Rouge LA 70809 20 2H 1 none 1 2 2 30403178 91104720MARY BIRD PERKINS CANCER CTR Henkelmann Gregory C. 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 >=18 1 2 2 30403178 91104720MARY BIRD PERKINS CANCER CTR Johnson Sheldon A. 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 >=18 1 2 1 30403178 91104720MARY BIRD PERKINS CANCER CTR King, Jr. Maurice L. 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 >=18 1 2 1 30403178 91104720MARY BIRD PERKINS CANCER CTR Levine Renee A. 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 >=18 1 2 2 30403178 91104720MARY BIRD PERKINS CANCER CTR Lo Kenneth K. 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 >=18 1 2 2 30403178 91104720MARY BIRD PERKINS CANCER CTR Long Jeffrey P. 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 >=18 1 2 2 30403178 91104720THE PHYSICIAN'S ALLIANCE CORP (TPAC) Patten Judd 4950 Essen Lane Baton Rouge LA 70809 20 2H 1 none 1 2 2 30403178 91104720MARY BIRD PERKINS CANCER CTR Sanders Mary Ella 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 >=18 1 2 2 30403178 91104720THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schmeeckle Kellie D. 4950 Essen Lane Baton Rouge LA 70809 20 2H 1 none 1 2 2 30403178 91104720THE PHYSICIAN'S ALLIANCE CORP (TPAC) Shih Kent 4950 Essen Lane Baton Rouge LA 70809 20 2H 1 none 1 2 2 30403178 91104720


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New Patient

Age Restricti

onPCP Link

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THE PHYSICIAN'S ALLIANCE CORP (TPAC) Spell Derrick 4950 Essen Lane Baton Rouge LA 70809 20 2H 1 none 1 2 2 30403178 91104720MARY BIRD PERKINS CANCER CTR Wood Charles G. 4950 Essen Lane Baton Rouge LA 70809 20 2J 1 >=18 1 2 2 30403178 91104720THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bienvenu Bryan 4950 Essen Lane, Ste 500 Baton Rouge LA 70809 20 2H 1 none 1 2 2 30403178 91104720HEALTH MANAGEMENT SERVICES Inc 5215 Essen Lane Baton Rouge LA 70809 40 54 1 none 1 2 2 30400532 91106028LINCARE INC 6215 HOLLYFIELD DR BATON ROUGE LA 70809 40 54 1 none 1 1 2 30390811 91052255THE PHYSICIAN'S ALLIANCE CORP (TPAC) Anderson Dwayne 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 1 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bruce Michael 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 2 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Collins Ted 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 2 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gibson Keith 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 2 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hayden Robert 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 1 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Majoria Ryan 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 1 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcneill Daniel 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 1 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morel Christian 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 1 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schuber Scott 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 1 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) St Amant Brandon 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 1 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tassin Gerard 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 1 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walker David 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 1 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) West Roger 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 2 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wofford Mark 7809 Jefferson Hwy B2 Baton Rouge LA 70809 20 30 1 none 1 2 2 30428295 91107272THE PHYSICIAN'S ALLIANCE CORP (TPAC) Anyanwoke Gertrude C. 7844 A Jefferson Place Blvd Baton Rouge LA 70809 20 2I 1 none 1 2 2 30403426 91070429THE PHYSICIAN'S ALLIANCE CORP (TPAC) Newsome Robert 7887 Picardy Ave Baton Rouge LA 70809 20 30 1 none 1 2 1 30397926 91106474REHABILITATION SPECIALTY EQUIPMENT Henriksen Paul Eric 7931 Picardy Ave. Suite A Baton Rouge LA 70809 40 54 1 >=18 1 2 2 30397669 91106149WAGUESPACK WENDY A OD Waguespack Wendy A. OD 7932 Picardy Ave., Ste. A Baton Rouge LA 70809 28 88 1 none 1 2 2 30397197 91105915LABCORP 7932 SUMMA AVE, #B-2 BATON ROUGE LA 70809 20 30 1 none 1 1 2 30400912 91104103CUSTOM HEALTHCARE INC Callahan Mike E. 7987 Pecue Lane Suite 1A Baton Rouge LA 70809 40 54 1 none 1 2 2 30378024 91040213THE PHYSICIAN'S ALLIANCE CORP (TPAC) Broussard Thad 8037 Picardy Ave Baton Rouge LA 70809 20 20 1 none 1 2 2 30397069 91105128

Armington William MD 8044 Summa Ave., Bldg 1 Ste B Baton Rouge LA 70809 20 30 1 none 1 2 2 30400349 91103113Ochsner Clinic Cook Janet White 8150 Jefferson Hwy. Baton Rouge LA 70809 20 08 1 None 1 2 2 30422671 91102750Ochsner Clinic Guarisco Christopher P. 8150 Jefferson Hwy. Baton Rouge LA 70809 20 41 1 >=18 1 2 2 30422671 91102750Ochsner Clinic Jo Jeannie Y. 8150 Jefferson Hwy. Baton Rouge LA 70809 32 48 1 none 1 2 2 30422671 91102750Ochsner Clinic Joshi Shobha N. 8150 Jefferson Hwy. Baton Rouge LA 70809 20 10 1 none 1 2 2 30422671 91102750Ochsner Clinic Muratore Karen A. 8150 Jefferson Hwy. Baton Rouge LA 70809 20 08 1 None 1 2 2 30422671 91102750Ochsner Clinic Ray Amy M. 8150 Jefferson Hwy. Baton Rouge LA 70809 19 08 1 None 1 2 2 30422671 91102750Ochsner Clinic Waddill James R. 8150 Jefferson Hwy. Baton Rouge LA 70809 20 08 1 None 1 2 2 30422671 91102750RADIOLOGY SPECIALISTS 8338 Summa Avenue Suite 100 Baton Rouge LA 70809 20 30 1 none 1 2 2 30398656 91100140HANGER PROSTHETICS AND ORTHOTICS 8522 Summa Avenue Baton Rouge LA 70809 40 53 1 none 1 2 1 30397674 91098006BAYOU RADIATION ONCOLOGY 8585 Picardy Baton Rouge LA 70809 20 2J 1 none 1 2 2 30392551 91093548THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brierre Stephen 8585 Picardy Baton Rouge LA 70809 20 29 1 none 1 2 2 30392551 91093548THE PHYSICIAN'S ALLIANCE CORP (TPAC) Culotta Roy 8585 Picardy Baton Rouge LA 70809 20 29 1 none 1 2 2 30392551 91093548BAYOU RADIATION ONCOLOGY Lauve Andrew D. MD 8585 Picardy Baton Rouge LA 70809 20 2J 1 none 1 2 2 30392551 91093548BAYOU RADIATION ONCOLOGY Russell William E. MD 8585 Picardy Baton Rouge LA 70809 20 2J 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Anderson Kevin J. MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Berrigan Donald Patrick CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Bienasz Stanley Michael MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Bollich Amiee Angelle CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Brignac Jennifer Lebert CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Castille Ross Victor CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Crochet Beth C. CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Dang Son Manh MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548

BATON ROUGE IMAGING/IMAGING AFFILIATES OF BATON ROUGE, LTC


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PARISH ANESTHESIA OF BATON ROUGE David Susan MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Davidson Joshua Burton CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Dunaway Stephanie Underwood CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Dunn, II Michael Bernard MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Eagleton Bernard E. MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Eyre Byron MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Freeman James Carlton MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Galliano Dante Juan MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Gaudin Rachel Lynn CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Hanks Michael D. MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Hardy Kyle David CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Hart Sarah Fields CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Hatch Grass Joellyn Mary CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Jones Jeremy CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Langley Brigitte Hernandez CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Legendre Adrianne CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Legnon Christopher Michael CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Maynard Timothy S. CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Morris, III Hershel Fisk CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Mynard Catherine Moss CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Odom Patrick Dickerson MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Olivier, III Roumay CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Pepper Clinton Stuart CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Rosinia Francis Anthony MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Saulny Marie Christina MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Schnebelen Kyle CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Scofield Sharon CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Sonnier Corey James CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Steele Barry Alan MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Stuprich Anthony V. CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Sukkar Mohammed Salim MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Tahir Ash H. MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Thibodeaux Wayne Joseph MD 8585 Picardy Avenue Baton Rouge LA 70809 20 05 1 none 1 2 2 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Vickers Michael Kent CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548PARISH ANESTHESIA OF BATON ROUGE Welch Clay CRNA 8585 Picardy Avenue Baton Rouge LA 70809 91 05 1 none 1 2 1 30392551 91093548THE PHYSICIAN'S ALLIANCE CORP (TPAC) 8595 Picardy Ave Suite 320 Baton Rouge LA 70809 20 30 1 none 1 2 2 30392588 91092869

Baton Rouge General - Bluebonnet 8595 Picardy Ave Baton Rouge LA 70809 60 2E 1 None 2 1 2 30392588 91092869

Baton Rouge General - Bluebonnet 8595 Picardy Ave Baton Rouge LA 70809 60 65 1 None 2 1 2 30392588 91092869

Baton Rouge General - Bluebonnet 8595 Picardy Ave Baton Rouge LA 70809 60 71 1 None 2 1 2 30392588 91092869

Baton Rouge General Medical Center 8595 Picardy Ave Baton Rouge LA 70809 60 86 1 None 2 1 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Berry Jarmeca 8595 Picardy Ave Suite 320 Baton Rouge LA 70809 78 79 1 >=18 1 2 2 30392588 91092869Burnham Family & Sports Medicine Burnham Jeffrey M MD 8595 Picardy Ave Ste 440 Baton Rouge LA 70809 20 08 1 None 2 1 2 30392588 91092869

Baton Rouge General - Bluebonnet





LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Baton Rouge General - Bluebonnet Jayasinghe Indra T MD 8595 Picardy Ave Baton Rouge LA 70809 20 41 1 >=18 2 1 2 30392588 91092869Baton Rouge Family Medical Center Minsky Louis R MD 8595 Picardy Ave Ste 100 Baton Rouge LA 70809 20 08 1 None 2 1 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sam, II Albert 8595 Picardy Ave Suite 320 Baton Rouge LA 70809 20 33 1 none 1 2 1 30392588 91092869Baton Rouge Family Medical Center Shamlin Kenyatta D MD 8595 Picardy Ave Ste 100 Baton Rouge LA 70809 20 41 1 >=18 2 1 2 30392588 91092869Baton Rouge Family Medical Center Shamlin Kenyatta D MD 8595 Picardy Ave Ste 100 Baton Rouge LA 70809 20 37 1 <=18 2 1 2 30392588 91092869Baton Rouge Family Medical Center Shamlin Tasha C MD 8595 Picardy Ave Ste 100 Baton Rouge LA 70809 20 41 1 >=18 2 1 2 30392588 91092869Baton Rouge Family Medical Center Shamlin Tasha C MD 8595 Picardy Ave Ste 100 Baton Rouge LA 70809 20 37 1 <=18 2 1 2 30392588 91092869Baton Rouge Family Medical Center St Amant Robert P MD 8595 Picardy Ave Ste 100 Baton Rouge LA 70809 20 08 1 None 2 1 2 30392588 91092869Baton Rouge General - Bluebonnet Thompson Mikah S MD 8595 Picardy Ave Baton Rouge LA 70809 20 41 1 >=18 2 1 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Tran Victor 8595 Picardy Ave Suite 320 Baton Rouge LA 70809 20 33 1 none 1 2 1 30392588 91092869Baton Rouge Family Medical Center Wood Robert C MD 8595 Picardy Ave Ste 100 Baton Rouge LA 70809 20 08 1 None 2 1 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fanous Nervin 8595 Picardy Ave Ste 320 Baton Rouge LA 70809 20 33 1 none 1 2 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Griffin Joseph 8595 Picardy Ave Ste 320 Baton Rouge LA 70809 20 33 1 none 1 2 1 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Keller Vern 8595 Picardy Ave Ste 320 Baton Rouge LA 70809 20 33 1 none 1 2 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Olinde Andrew 8595 Picardy Ave Ste 320 Baton Rouge LA 70809 20 33 1 none 1 2 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bostick Peter 8595 Picardy Ave, Ste 200 Baton Rouge LA 70809 20 02 1 none 1 2 1 30392588 91092869The Center for Women's Healthcare 8595 Picardy Avenue Suite 230 Baton Rouge LA 70809 20 16 1 >=16 1 2 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Abernathy Deborah 8595 Picardy Avenue Suite 400 Baton Rouge LA 70809 20 2H 1 none 1 2 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Castine, III Michael 8595 Picardy Avenue Suite 400 Baton Rouge LA 70809 20 2H 1 none 1 2 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Cataldo Vince D 8595 Picardy Avenue Suite 400 Baton Rouge LA 70809 20 2H 1 none 1 2 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mccanless Christopher 8595 Picardy Avenue Baton Rouge LA 70809 20 2H 1 none 1 2 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Miletello Gerald 8595 Picardy Avenue Suite 400 Baton Rouge LA 70809 20 2H 1 none 1 2 2 30392588 91092869The Center for Women's Healthcare Patin Carol M. MD 8595 Picardy Avenue Suite 230 Baton Rouge LA 70809 20 16 1 >=16 1 2 1 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reine Georgia 8595 Picardy Avenue Suite 400 Baton Rouge LA 70809 20 2H 1 none 1 2 2 30392588 91092869The Center for Women's Healthcare Thomas-Jingles Cassandra 8595 Picardy Avenue Suite 230 Baton Rouge LA 70809 78 16 1 >=16 1 2 2 30392588 91092869THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kramm Paul 8595 United Plaza Blvd Suite 200 Baton Rouge LA 70809 35 65 1 none 1 2 2 30410358 91095859DIVERSIFIED PROFESSIONALS INC Alexander Carolyn 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Badeaux Brian 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Broussard Nicholas 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Chustz Bert J. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Cobb Susan J. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC David Amy T. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC David Susan 8946 Interline Ave Ste C Baton Rouge LA 70809 20 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC DeFraites Wanda C. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 1 30419853 91087114DIVERSIFIED PROFESSIONALS INC Dileo John L. MD 8946 Interline Ave Ste C Baton Rouge LA 70809 20 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Eagleton Bernard 8946 Interline Ave Ste C Baton Rouge LA 70809 20 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Ewen Mitch P. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Francois Douglas 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 1 30419853 91087114DIVERSIFIED PROFESSIONALS INC Fried Pat M. 8946 Interline Ave Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Gardiner Scott P. 8946 Interline Ave Ste C Baton Rouge LA 70809 20 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Gaudet Kelly M. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Graham Nolan K. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 1 30419853 91087114DIVERSIFIED PROFESSIONALS INC Heffernan Dennis C. 8946 Interline Ave Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC LeBlanc Jeffrey P. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Mackey Brian C. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 1 30419853 91087114DIVERSIFIED PROFESSIONALS INC McCaulley Samuel S. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC McFarland Achontyrausi 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 1 30419853 91087114DIVERSIFIED PROFESSIONALS INC Murdoch Nancy 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Newman Richard 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Pedersen Gerald 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 1 30419853 91087114


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

DIVERSIFIED PROFESSIONALS INC Sikes John M. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 1 30419853 91087114DIVERSIFIED PROFESSIONALS INC Steele Barry 8946 Interline Ave Ste C Baton Rouge LA 70809 20 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Sukkar Salim M. S. 8946 Interline Ave Ste C Baton Rouge LA 70809 20 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Thibodeaux Wayne 8946 Interline Ave Ste C Baton Rouge LA 70809 20 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Toler Michael 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 2 30419853 91087114DIVERSIFIED PROFESSIONALS INC Welch Clay T. 8946 Interline Ave Ste C Baton Rouge LA 70809 91 05 1 none 1 2 1 30419853 91087114Ochsner Clinic Abi-Samra Freddy M. 9001 Summa Ave. Baton Rouge LA 70809 20 06 1 none 1 2 2 30393701 91092507Ochsner Clinic Alleva David Q. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Belleville Francine 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Bethea Yevette 9001 Summa Ave. Baton Rouge LA 70809 34 64 1 none 1 2 2 30393701 91092507Ochsner Clinic Bluth Edward I. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Braden Chad C. K. 9001 Summa Ave. Baton Rouge LA 70809 20 08 1 None 1 2 2 30393701 91092507Ochsner Clinic Brooks, Jr. Burke Jay 9001 Summa Ave. Baton Rouge LA 70809 20 2H 1 none 1 2 2 30393701 91092507Ochsner Clinic Broussard Brenda 9001 Summa Ave. Baton Rouge LA 70809 78 16 1 >=16 1 2 2 30393701 91092507Ochsner Clinic Cauley M. Lynn 9001 Summa Ave. Baton Rouge LA 70809 28 88 1 none 1 2 2 30393701 91092507Ochsner Clinic Cauley Stephanie L. PT 9001 Summa Ave. Baton Rouge LA 70809 28 88 1 none 1 2 2 30393701 91092507Ochsner Clinic Cederbom Gunnar 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Chandler Nancy D. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Cleland Bruce P. 9001 Summa Ave. Baton Rouge LA 70809 20 02 1 none 1 2 2 30393701 91092507Ochsner Clinic Coleman Kodi Crisp 9001 Summa Ave. Baton Rouge LA 70809 20 08 1 None 1 2 2 30393701 91092507Ochsner Clinic Cook Janet White 9001 Summa Ave. Baton Rouge LA 70809 20 08 1 None 1 2 2 30393701 91092507Ochsner Clinic Cook Thelma S. 9001 Summa Ave. Baton Rouge LA 70809 78 79 1 >=18 1 2 2 30393701 91092507Ochsner Clinic Cothern Andrea 9001 Summa Ave. Baton Rouge LA 70809 78 08 1 None 1 2 2 30393701 91092507Ochsner Clinic Creed J. Curtis 9001 Summa Ave. Baton Rouge LA 70809 20 18 1 none 1 2 2 30393701 91092507Ochsner Clinic Cunningham Robert J. 9001 Summa Ave. Baton Rouge LA 70809 20 2K 1 none 1 2 2 30393701 91092507Ochsner Clinic Dauterive F. Ralph 9001 Summa Ave. Baton Rouge LA 70809 20 16 1 >=16 1 2 2 30393701 91092507Ochsner Clinic David Cathy D. 9001 Summa Ave. Baton Rouge LA 70809 78 08 1 >=18 1 2 2 30393701 91092507Ochsner Clinic DeVun Daniel 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Diethelm Nancy E. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Dowling Adam M. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Ducos Rafael S. PT 9001 Summa Ave. Baton Rouge LA 70809 20 2H 1 none 1 2 2 30393701 91092507Ochsner Clinic Dupre' Bobby J. 9001 Summa Ave. Baton Rouge LA 70809 20 2M 1 none 1 2 2 30393701 91092507Ochsner Clinic Durel Michael S. 9001 Summa Ave. Baton Rouge LA 70809 20 16 1 >=16 1 2 1 30393701 91092507Ochsner Clinic Eick John J. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Emerson Noah A. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 1 30393701 91092507Ochsner Clinic Erffmeyer John E. 9001 Summa Ave. Baton Rouge LA 70809 20 03 1 none 1 2 2 30393701 91092507Ochsner Clinic Fabrega Ruben D. 9001 Summa Ave. Baton Rouge LA 70809 20 2H 1 none 1 2 2 30393701 91092507Ochsner Clinic Fairley Thomas R. 9001 Summa Ave. Baton Rouge LA 70809 28 88 1 none 1 2 2 30393701 91092507Ochsner Clinic Gaddis Kenneth A. 9001 Summa Ave. Baton Rouge LA 70809 20 13 1 none 1 2 2 30393701 91092507Ochsner Clinic Gahn Catherine 9001 Summa Ave. Baton Rouge LA 70809 78 79 1 >=18 1 2 2 30393701 91092507Ochsner Clinic Genre Bethanie 9001 Summa Ave. Baton Rouge LA 70809 90 16 1 >=16 1 2 2 30393701 91092507Ochsner Clinic Genre Charles F. 9001 Summa Ave. Baton Rouge LA 70809 20 22 1 none 1 2 2 30393701 91092507Ochsner Clinic Gick Stephen A. 9001 Summa Ave. Baton Rouge LA 70809 20 20 1 none 1 2 2 30393701 91092507Ochsner Clinic Golightly George 9001 Summa Ave. Baton Rouge LA 70809 20 02 1 none 1 2 2 30393701 91092507Ochsner Clinic Gomes Glenn M. 9001 Summa Ave. Baton Rouge LA 70809 20 29 1 none 1 2 2 30393701 91092507Ochsner Clinic Grenier Christopher P. 9001 Summa Ave. Baton Rouge LA 70809 20 18 1 none 1 2 2 30393701 91092507Ochsner Clinic Griffin Ewelina B. 9001 Summa Ave. Baton Rouge LA 70809 20 16 1 >=16 1 2 2 30393701 91092507Ochsner Clinic Hall Cynthia 9001 Summa Ave. Baton Rouge LA 70809 78 79 1 >=18 1 2 2 30393701 91092507Ochsner Clinic Hedges Sharon Y. 9001 Summa Ave. Baton Rouge LA 70809 20 16 1 >=16 1 2 2 30393701 91092507Ochsner Clinic Hernandez Lincoln 9001 Summa Ave. Baton Rouge LA 70809 20 10 1 none 1 2 2 30393701 91092507


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Ho Khanh T. 9001 Summa Ave. Baton Rouge LA 70809 20 2M 1 none 1 2 2 30393701 91092507Ochsner Clinic Hogan Jennifer V. PT 9001 Summa Ave. Baton Rouge LA 70809 20 37 1 <=18 1 2 2 30393701 91092507Ochsner Clinic Holder Sharon D. 9001 Summa Ave. Baton Rouge LA 70809 78 79 1 >=18 1 2 2 30393701 91092507Ochsner Clinic Howard George W. 9001 Summa Ave. Baton Rouge LA 70809 20 10 1 none 1 2 2 30393701 91092507Ochsner Clinic Hubbs Melissa 9001 Summa Ave. Baton Rouge LA 70809 78 79 1 >=18 1 2 2 30393701 91092507Ochsner Clinic Husserl Fred E. 9001 Summa Ave. Baton Rouge LA 70809 20 2K 1 none 1 2 2 30393701 91092507Ochsner Clinic Huynh Trang P. 9001 Summa Ave. Baton Rouge LA 70809 20 16 1 >=16 1 2 2 30393701 91092507Ochsner Clinic Jeansonne Louis O. 9001 Summa Ave. Baton Rouge LA 70809 20 02 1 none 1 2 2 30393701 91092507Ochsner Clinic Jo Jeannie Y. 9001 Summa Ave. Baton Rouge LA 70809 32 48 1 none 1 2 2 30393701 91092507Ochsner Clinic Johnson Jennifer 9001 Summa Ave. Baton Rouge LA 70809 78 16 1 >=16 1 2 2 30393701 91092507Ochsner Clinic Jones Brian P. 9001 Summa Ave. Baton Rouge LA 70809 20 06 1 none 1 2 2 30393701 91092507Ochsner Clinic Kalmar John A. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 1 30393701 91092507Ochsner Clinic Kamyar Amin 9001 Summa Ave. Baton Rouge LA 70809 20 2K 1 none 1 2 2 30393701 91092507Ochsner Clinic Kay Dennis 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Kenney, III Arthur J. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 1 30393701 91092507Ochsner Clinic Khan Abdul B. 9001 Summa Ave. Baton Rouge LA 70809 20 13 1 none 1 2 2 30393701 91092507Ochsner Clinic Khuri Bahij N. 9001 Summa Ave. Baton Rouge LA 70809 20 06 1 none 1 2 2 30393701 91092507Ochsner Clinic King Teresa L. 9001 Summa Ave. Baton Rouge LA 70809 20 04 1 none 1 2 2 30393701 91092507Ochsner Clinic Klump Micah 9001 Summa Ave. Baton Rouge LA 70809 34 64 1 none 1 2 2 30393701 91092507Ochsner Clinic Kober Alicia C. 9001 Summa Ave. Baton Rouge LA 70809 20 37 1 <=18 1 2 2 30393701 91092507Ochsner Clinic Layman Todd E. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 1 30393701 91092507Ochsner Clinic LeJeune Elizabeth 9001 Summa Ave. Baton Rouge LA 70809 78 79 1 >=18 1 2 2 30393701 91092507Ochsner Clinic Lindsey Stephen M. PT 9001 Summa Ave. Baton Rouge LA 70809 20 2M 1 none 1 2 2 30393701 91092507Ochsner Clinic Liokis Evangelos A. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Longe Ade C. 9001 Summa Ave. Baton Rouge LA 70809 20 13 1 none 1 2 2 30393701 91092507Ochsner Clinic Lotterman Craig D. 9001 Summa Ave. Baton Rouge LA 70809 20 2H 1 none 1 2 2 30393701 91092507Ochsner Clinic Mann Christina A. 9001 Summa Ave. Baton Rouge LA 70809 78 16 1 >=16 1 2 2 30393701 91092507Ochsner Clinic Mason Glen A. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Matthews Charles C. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic McAlister Becki A. 9001 Summa Ave. Baton Rouge LA 70809 78 79 1 >=18 1 2 2 30393701 91092507Ochsner Clinic McGrath Stephanie J. 9001 Summa Ave. Baton Rouge LA 70809 20 29 1 none 1 2 2 30393701 91092507Ochsner Clinic McKnight Melanie J. PT 9001 Summa Ave. Baton Rouge LA 70809 20 2K 1 none 1 2 2 30393701 91092507Ochsner Clinic McNamara Susan N. PT 9001 Summa Ave. Baton Rouge LA 70809 20 41 1 >=18 1 2 2 30393701 91092507Ochsner Clinic McRae Molly E. 9001 Summa Ave. Baton Rouge LA 70809 78 16 1 >=16 1 2 2 30393701 91092507Ochsner Clinic Menard Ronald D. 9001 Summa Ave. Baton Rouge LA 70809 20 08 1 None 1 2 2 30393701 91092507Ochsner Clinic Mendoza Douglas K. 9001 Summa Ave. Baton Rouge LA 70809 20 06 1 none 1 2 1 30393701 91092507Ochsner Clinic Mikdadi Ghiath M. 9001 Summa Ave. Baton Rouge LA 70809 20 06 1 none 1 2 1 30393701 91092507Ochsner Clinic Milburn Cristina I. PT 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Milburn James M. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 1 30393701 91092507Ochsner Clinic Monaco Bruce R. 9001 Summa Ave. Baton Rouge LA 70809 20 20 1 none 1 2 2 30393701 91092507Ochsner Clinic Morgan Michael G. 9001 Summa Ave. Baton Rouge LA 70809 20 18 1 none 1 2 2 30393701 91092507Ochsner Clinic Moussa Khalid M. 9001 Summa Ave. Baton Rouge LA 70809 20 10 1 none 1 2 2 30393701 91092507Ochsner Clinic Nachar Oussama 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Narang Jhumka Ghosh 9001 Summa Ave. Baton Rouge LA 70809 20 2K 1 none 1 2 2 30393701 91092507Ochsner Clinic Newman Colleen 9001 Summa Ave. Baton Rouge LA 70809 78 16 1 >=16 1 2 1 30393701 91092507Ochsner Clinic Padigala Kiran K. 9001 Summa Ave. Baton Rouge LA 70809 20 2K 1 none 1 2 2 30393701 91092507Ochsner Clinic Parmar Vikram S. 9001 Summa Ave. Baton Rouge LA 70809 20 20 1 none 1 2 2 30393701 91092507Ochsner Clinic Patel Deepesh Rubin 9001 Summa Ave. Baton Rouge LA 70809 20 41 1 >=18 1 2 2 30393701 91092507Ochsner Clinic Payne Thomas N. 9001 Summa Ave. Baton Rouge LA 70809 20 16 1 >=16 1 2 1 30393701 91092507Ochsner Clinic Petty Catherine A. 9001 Summa Ave. Baton Rouge LA 70809 20 20 1 none 1 2 2 30393701 91092507


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Ochsner Clinic Prats, Jr. Lester J. 9001 Summa Ave. Baton Rouge LA 70809 20 34 1 none 1 2 2 30393701 91092507Ochsner Clinic Prempeh Osei B. 9001 Summa Ave. Baton Rouge LA 70809 20 08 1 None 1 2 2 30393701 91092507Ochsner Clinic Prescott Sydney C. 9001 Summa Ave. Baton Rouge LA 70809 79 79 1 >=18 1 2 2 30393701 91092507Ochsner Clinic Quintal, Sr. Errol J. PT 9001 Summa Ave. Baton Rouge LA 70809 20 07 1 none 1 2 2 30393701 91092507Ochsner Clinic Rabalais Amy G. 9001 Summa Ave. Baton Rouge LA 70809 20 04 1 none 1 2 2 30393701 91092507Ochsner Clinic Randal Cheryl D. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Restrepo Robert 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Roberts Andrew B. 9001 Summa Ave. Baton Rouge LA 70809 20 05 1 none 1 2 2 30393701 91092507Ochsner Clinic Rodwig, Jr. Francis R. 9001 Summa Ave. Baton Rouge LA 70809 20 22 1 none 1 2 1 30393701 91092507Ochsner Clinic Roy Praveen K. 9001 Summa Ave. Baton Rouge LA 70809 20 10 1 none 1 2 2 30393701 91092507Ochsner Clinic Rushing Lisa 9001 Summa Ave. Baton Rouge LA 70809 78 79 1 >=18 1 2 2 30393701 91092507Ochsner Clinic Russo Aldo J. 9001 Summa Ave. Baton Rouge LA 70809 20 10 1 none 1 2 2 30393701 91092507Ochsner Clinic Sanner William H. 9001 Summa Ave. Baton Rouge LA 70809 32 48 1 none 1 2 2 30393701 91092507Ochsner Clinic Scherer, III Carl W. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Shannon Sean E. 9001 Summa Ave. Baton Rouge LA 70809 20 2M 1 none 1 2 2 30393701 91092507Ochsner Clinic Sharon Marius S. 9001 Summa Ave. Baton Rouge LA 70809 20 06 1 none 1 2 2 30393701 91092507Ochsner Clinic Sledge, Jr. E. David 9001 Summa Ave. Baton Rouge LA 70809 20 41 1 >=18 1 2 2 30393701 91092507Ochsner Clinic Smetherman Dana H. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Sossaman Gregory N. 9001 Summa Ave. Baton Rouge LA 70809 20 22 1 none 1 2 1 30393701 91092507Ochsner Clinic Sossaman Julie G. PT 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Stringfellow Mary V. 9001 Summa Ave. Baton Rouge LA 70809 20 2H 1 none 1 2 2 30393701 91092507Ochsner Clinic Sullivan Michael A. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Teaford T. Lamar 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 2 30393701 91092507Ochsner Clinic Tellis Claude J. 9001 Summa Ave. Baton Rouge LA 70809 20 29 1 none 1 2 2 30393701 91092507Ochsner Clinic Tupler Richard H. 9001 Summa Ave. Baton Rouge LA 70809 20 30 1 none 1 2 1 30393701 91092507Ochsner Clinic Urrego Fernando A. 9001 Summa Ave. Baton Rouge LA 70809 20 29 1 none 1 2 1 30393701 91092507Ochsner Clinic Vasireddy Sreekanth 9001 Summa Ave. Baton Rouge LA 70809 20 2H 1 none 1 2 2 30393701 91092507Ochsner Clinic Velazquez Salvador 9001 Summa Ave. Baton Rouge LA 70809 20 06 1 none 1 2 2 30393701 91092507Ochsner Clinic Warrier Rajasekharan P. 9001 Summa Ave. Baton Rouge LA 70809 20 2H 1 none 1 2 2 30393701 91092507Ochsner Clinic Winters J. Christian 9001 Summa Ave. Baton Rouge LA 70809 20 34 1 none 1 2 2 30393701 91092507THE PHYSICIAN'S ALLIANCE CORP (TPAC) Alapati Satyaprasad 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Anderson William A. 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Be Robert M. 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Berggreen Charles 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Christensen Christopher 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fusilier Gregory 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leo Ronald 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lobrano Amy 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcdonald John W. 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mullins Walter 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nelson Andrew 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Oubre Benton 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rao Maheswar 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Reddy Neelima G 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walsh Douglas 9103 Jefferson Hwy Baton Rouge LA 70809 20 10 1 none 1 2 2 30415504 91086398THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bice Tulsi 9118 Bluebonnet Centre Blvd Baton Rouge LA 70809 35 65 1 none 1 2 2 30397616 91085887THE PHYSICIAN'S ALLIANCE CORP (TPAC) Murphy Brian 9118 Bluebonnet Centre Blvd Baton Rouge LA 70809 20 13 1 none 1 2 2 30397616 91085887THE PHYSICIAN'S ALLIANCE CORP (TPAC) Patel Alpesh 9118 Bluebonnet Centre Blvd Baton Rouge LA 70809 20 05 1 none 1 2 2 30397616 91085887THE PHYSICIAN'S ALLIANCE CORP (TPAC) Russo-stringer Elizabeth 9118 Bluebonnet Centre Blvd Baton Rouge LA 70809 20 05 1 none 1 2 2 30397616 91085887THE PHYSICIAN'S ALLIANCE CORP (TPAC) Weitz Sandra 9118 Bluebonnet Centre Blvd Baton Rouge LA 70809 20 05 1 none 1 2 2 30397616 91085887


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

SYNERGY HOME CARE-CAPITOL REGION INC 9843 Interline Ave Baton Rouge LA 70809 44 75 1 none 1 2 2 30426632 91077696AUDIBEL HEARING HEALTHCARE 10761 Perkins Rd Ste B Baton Rouge LA 70810 34 64 1 none 1 2 2 30376119 91091527THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barber Gerald 12525 Perkins Rd Baton Rouge LA 70810 20 08 1 none 1 2 2 30369654 91078359THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brignac Donald 12525 Perkins Rd Baton Rouge LA 70810 20 08 1 none 1 2 2 30369654 91078359THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chamberlain Matthew 12525 Perkins Rd Baton Rouge LA 70810 20 08 1 none 1 2 2 30369654 91078359THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chamberlain Matthew 12525 Perkins Rd Baton Rouge LA 70810 20 41 1 >=18 1 2 2 30369654 91078359THE PHYSICIAN'S ALLIANCE CORP (TPAC) Davidson Douglas 12525 Perkins Rd Ste B Baton Rouge LA 70810 20 08 1 none 1 2 2 30369654 91078359THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fillman Robert 12525 Perkins Rd Baton Rouge LA 70810 20 41 1 >=18 1 2 2 30369654 91078359THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 12525 Perkins Rd Baton Rouge LA 70810 20 03 1 none 1 2 2 30369654 91078359THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 12525 Perkins Rd Baton Rouge LA 70810 20 08 1 none 1 2 2 30369654 91078359THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 12525 Perkins Rd Baton Rouge LA 70810 20 41 1 >=18 1 2 2 30369654 91078359Abbott Eye Clinic Abbott Michael D OD 12726 Perkins Rd Baton Rouge LA 70810 28 88 1 None 1 2 2 30368668 91076238ABBOTT MICHAEL D OD Abbott Michael D. OD 12726 Perkins Rd. Baton Rouge LA 70810 28 88 1 none 1 2 2 30368668 91076238ACHORD SHONDA OD Achord Shonda OD 12726 Perkins Rd. Baton Rouge LA 70810 28 88 1 none 1 2 2 30368668 91076238THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lovell Cecil 13841 Perkins Rd Baton Rouge LA 70810 20 08 1 None 1 2 2 30364761 91063708THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lejeune Geof 16645 Highland Road Baton Rouge LA 70810 35 65 1 none 1 2 2 30346127 91043646THE PHYSICIAN'S ALLIANCE CORP (TPAC) Roy Brandon 16645 Highland Road Baton Rouge LA 70810 35 65 1 none 1 2 2 30346127 91043646BATON ROUGE ORTHO & PROSTHET 5745 Essen Lane Ste 105 Baton Rouge LA 70810 40 53 1 none 1 2 1 30396482 91108573Quest Diagnostics 7731 Perkins Rd Ste 155 Baton Rouge LA 70810 20 30 1 none 1 1 2 30393873 91108004THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hansbrough Thomas 8080 Bluebonnet Ste 2121 Baton Rouge LA 70810 20 04 1 none 1 2 1 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Peters, Jr. Stanley 8080 Bluebonnet Ste 2121 Baton Rouge LA 70810 20 04 1 none 1 2 1 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Traxler Jon 8080 Bluebonnet Ste 2121 Baton Rouge LA 70810 20 04 1 none 1 2 1 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Smither Anna R. 8080 Bluebonnet #3000 Baton Rouge LA 70810 20 34 1 none 1 2 2 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Blue, III Kenneth 8080 Bluebonnet Blvd Ste 3000 Baton Rouge LA 70810 20 34 1 none 1 2 2 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Braud Cheryl 8080 Bluebonnet Blvd Ste 2222 Baton Rouge LA 70810 20 04 1 none 1 2 1 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Braud Lawrence 8080 Bluebonnet Blvd Blvd Ste 2222 Baton Rouge LA 70810 20 04 1 none 1 2 2 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Breaux Jack 8080 Bluebonnet Blvd Ste 2222 Baton Rouge LA 70810 20 04 1 none 1 2 1 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Katzenmeyer William 8080 Bluebonnet Blvd Ste 2222 Baton Rouge LA 70810 20 04 1 none 1 2 1 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Kubricht, III William 8080 Bluebonnet Blvd Suite 3000 Baton Rouge LA 70810 20 34 1 none 1 2 2 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Murphy Lynn 8080 Bluebonnet Blvd Ste 2222 Baton Rouge LA 70810 20 04 1 none 1 2 1 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Scallan Patricia 8080 Bluebonnet Blvd Suite 2121 Baton Rouge LA 70810 20 04 1 none 1 2 1 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Grissom Robert 8080 Bluebonnet Blvd Ste 3000 Baton Rouge LA 70810 20 34 1 none 1 2 2 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hastings David 8080 Bluebonnet Blvd Ste 3000 Baton Rouge LA 70810 20 34 1 none 1 2 2 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hollier Henry 8080 Bluebonnet Blvd Ste 3000 Baton Rouge LA 70810 20 34 1 none 1 2 1 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wall William 8080 Bluebonnet Blvd Ste 3000 Baton Rouge LA 70810 20 34 1 none 1 2 2 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wexler Harold 8080 Bluebonnet Blvd Ste 3000 Baton Rouge LA 70810 20 34 1 none 1 2 2 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Carter Richard 8080 Bluebonnet Blvd Ste 30000 Baton Rouge LA 70810 20 34 1 none 1 2 2 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Taylor Robert 8080 Bluebonnet Blvd Ste 30000 Baton Rouge LA 70810 20 34 1 none 1 2 2 30377213 91099269THE PHYSICIAN'S ALLIANCE CORP (TPAC) Richardson Clif 8160 Ymca Plaza Ste C Baton Rouge LA 70810 32 48 1 none 1 2 2 30373277 91076292JANE CURRY Curry Jane E. MD 8235 YMCA Plaza Dr., Ste. 100 Baton Rouge LA 70810 20 37 1 <=18 1 2 1 30371379 91077074Eye Medical Center Pearce Allen R MD 8913 Bluebonnet Blvd Baton Rouge LA 70810 20 18 1 None 2 1 2 30368282 91103154Eye Medical Center Wood Jeremy MD 8913 Bluebonnet Blvd Baton Rouge LA 70810 20 18 1 None 2 1 2 30368282 91103154THE PHYSICIAN'S ALLIANCE CORP (TPAC) Delabretonne Gaston 9032 Perkins Road Baton Rouge LA 70810 20 07 1 none 1 2 2 30383933 91102246THE PHYSICIAN'S ALLIANCE CORP (TPAC) Thomas Marykutty 9241 Bluebonnet Blvd., Ste B Baton Rouge LA 70810 20 08 1 None 1 2 2 30364435 91104454JOHNNIE LYNN HUNT 9804 BLUEBONNET BOULEVARD SUITE A BATON ROUGE LA 70810 32 48 1 none 1 1 2 30357280 91109028PREFERRED MEDICAL EQUIPMENT & SUPPLIES 6310 Merrydale Ave. Baton Rouge LA 70812 40 54 1 none 1 2 2 30498416 91128015MARIANS MEDICAL SUPPLIES LLC 11447 Florida Blvd. Baton Rouge LA 70815 40 54 1 none 1 2 2 30459438 91056627REGIONAL MEDICAL RENTAL & SALES 11712 Florida Blvd. Baton Rouge LA 70815 40 54 1 none 1 2 2 30459259 91053289XUONG DAO Dao Xuong MD 12389 Florida Blvd Baton Rouge LA 70815 20 41 1 >=18 1 2 1 30461262 91045186ACTION REHAB AND SUPPLY INC 1443 Delplaza, Ste. 6 Baton Rouge LA 70815 40 54 1 none 1 2 1 30438953 91083937


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Andrews Ronald 8894 Airline Hwy #q Baton Rouge LA 70815 20 08 1 None 1 2 1 30448135 91092946THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schwartzenburg Cheree 900 Airline Hwy Ste 230 Baton Rouge LA 70815 20 16 1 >=16 1 2 2 30466711 91043767ASSOCIATES IN PEDIATRIC DENTISTRY 9000 AIRLINE HIGHWAY SUITE 100 BATON ROUGE LA 70815 32 48 1 none 1 1 2 30447425 91092228WOMANS HOSPITAL FOUNDATION Diket Albert L. MD 9000 Airline Highway Ste 370 Baton Rouge LA 70815 20 16 1 >=16 1 2 1 30447425 91092228WOMANS HOSPITAL FOUNDATION Newman Mark G. MD 9000 Airline Highway Ste 370 Baton Rouge LA 70815 20 16 1 >=16 1 2 1 30447425 91092228WOMANS HOSPITAL FOUNDATION St. Amant Marshall MD 9000 Airline Highway Baton Rouge LA 70815 20 16 1 >=16 1 2 1 30447425 91092228WOMANS HOSPITAL FOUNDATION Stedman Charles MD 9000 Airline Highway Ste 370 Baton Rouge LA 70815 20 16 1 >=16 1 2 1 30447425 91092228WOMANS HOSPITAL FOUNDATION Veillon, Jr. Edward MD 9000 Airline Highway Ste 370 Baton Rouge LA 70815 20 16 1 >=16 1 2 1 30447425 91092228LA HEMATOLOGY ONCOLOGY ASSOCIATES Bienvenu Bryan J. 9000 Airline Hwy Ste 290 Baton Rouge LA 70815 20 2H 1 >=18 1 2 2 30447425 91092228LA HEMATOLOGY ONCOLOGY ASSOCIATES Billings, III Frederic T. 9000 Airline Hwy Ste 290 Baton Rouge LA 70815 20 2H 1 >=18 1 2 2 30447425 91092228THE PHYSICIAN'S ALLIANCE CORP (TPAC) Estes Jacob 9000 Airline Hwy Suite 210 Baton Rouge LA 70815 20 16 1 >=16 1 2 2 30447425 91092228THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hailey Michael 9000 Airline Hwy Ste 250 Baton Rouge LA 70815 20 02 1 none 1 2 1 30447425 91092228LA HEMATOLOGY ONCOLOGY ASSOCIATES Hanson David S. 9000 Airline Hwy Ste 290 Baton Rouge LA 70815 20 2H 1 >=18 1 2 2 30447425 91092228LA HEMATOLOGY ONCOLOGY ASSOCIATES Patten Judd E. 9000 Airline Hwy Ste 290 Baton Rouge LA 70815 20 2H 1 >=18 1 2 2 30447425 91092228LA HEMATOLOGY ONCOLOGY ASSOCIATES Schmeeckle Kellie D. 9000 Airline Hwy Ste 290 Baton Rouge LA 70815 20 2H 1 >=18 1 2 2 30447425 91092228THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schwartzenburg Clifford 9000 Airline Hwy Ste 230 Baton Rouge LA 70815 20 16 1 >=16 1 2 2 30447425 91092228THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schwartzenburg Edward 9000 Airline Hwy Ste 230 Baton Rouge LA 70815 20 16 1 >=16 1 2 2 30447425 91092228THE PHYSICIAN'S ALLIANCE CORP (TPAC) Schwartzenburg Ellis 9000 Airline Hwy Ste 230 Baton Rouge LA 70815 20 16 1 >=16 1 2 2 30447425 91092228LA HEMATOLOGY ONCOLOGY ASSOCIATES Spell Derrick W. 9000 Airline Hwy Ste 290 Baton Rouge LA 70815 20 2H 1 >=18 1 2 2 30447425 91092228WOMANS HOSPITAL FOUNDATION 9000 Airline Hwy, Ste. 240 Baton Rouge LA 70815 20 37 1 <=18 1 2 2 30447425 91092228WOMANS HOSPITAL FOUNDATION Hollman Charlotte MD 9000 Airline Hwy, Ste. 240 Baton Rouge LA 70815 20 13 1 none 1 2 2 30447425 91092228WOMANS HOSPITAL FOUNDATION Ortenberg Joseph MD 9000 Airline Hwy, Ste. 240 Baton Rouge LA 70815 20 34 1 none 1 2 1 30447425 91092228WOMANS HOSPITAL FOUNDATION Paterson Martha MD 9000 Airline Hwy, Ste. 240 Baton Rouge LA 70815 20 41 1 >=18 1 2 2 30447425 91092228WOMANS HOSPITAL FOUNDATION Schexnayder Lalania MD 9000 Airline Hwy, Ste. 240 Baton Rouge LA 70815 20 13 1 none 1 2 2 30447425 91092228WOMANS HOSPITAL FOUNDATION Warner Meredith 9000 Airline Hwy, Ste. 240 Baton Rouge LA 70815 20 20 1 none 1 2 2 30447425 91092228WOMANS HOSPITAL FOUNDATION 9050 Airline Highway Baton Rouge LA 70815 20 16 1 >=16 1 2 2 30445353 91090751WOMANS HOSPITAL FOUNDATION 9050 Airline Highway Baton Rouge LA 70815 60 86 1 none 1 2 2 30445353 91090751WOMANS HOSPITAL FOUNDATION Benanti Jan MD 9050 Airline Hwy Baton Rouge LA 70815 20 16 1 >=16 1 2 1 30445353 91090751WOMANS HOSPITAL FOUNDATION Breaux Jeffrey MD 9050 Airline Hwy Baton Rouge LA 70815 20 16 1 >=16 1 2 1 30445353 91090751WOMANS HOSPITAL FOUNDATION Foret Edison MD 9050 Airline Hwy Baton Rouge LA 70815 20 16 1 >=16 1 2 1 30445353 91090751WOMANS HOSPITAL FOUNDATION Kincade Tessa MD 9050 Airline Hwy Baton Rouge LA 70815 20 1T 1 none 1 2 2 30445353 91090751WOMANS HOSPITAL FOUNDATION Leggio Michael MD 9050 Airline Hwy Baton Rouge LA 70815 20 16 1 >=16 1 2 2 30445353 91090751THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bordelon Caroline 9534 Delcourt Ave Baton Rouge LA 70815 35 65 1 none 1 2 2 30437010 91083775THE PHYSICIAN'S ALLIANCE CORP (TPAC) Fabre Nicole 9534 Delcourt Ave Baton Rouge LA 70815 35 65 1 none 1 2 2 30437010 91083775Tiger Vision, LLC Bowman Jonathan OD 10423 Old Hammond Hwy Baton Rouge LA 70816 28 88 1 none 1 2 2 30433546 91070602Tiger Vision, LLC Coullard Glenn OD 10423 Old Hammond Hwy Baton Rouge LA 70816 28 88 1 none 1 2 2 30433546 91070602Tiger Vision, LLC Guildry Gerard MD 10423 Old Hammond Hwy Baton Rouge LA 70816 20 18 1 none 1 2 2 30433546 91070602Tiger Vision, LLC Haley Henry MD 10423 Old Hammond Hwy Baton Rouge LA 70816 20 18 1 none 1 2 2 30433546 91070602Tiger Vision, LLC Hendricks Sean MD 10423 Old Hammond Hwy Baton Rouge LA 70816 20 18 1 none 1 2 2 30433546 91070602Tiger Vision, LLC Nelson Scott MD 10423 Old Hammond Hwy Baton Rouge LA 70816 20 18 1 none 1 2 2 30433546 91070602Tiger Vision, LLC Nolan Charles OD 10423 Old Hammond Hwy Baton Rouge LA 70816 28 88 1 none 1 2 2 30433546 91070602Tiger Vision, LLC Saleem Amir CRNA 10423 Old Hammond Hwy Baton Rouge LA 70816 91 05 1 none 1 2 1 30433546 91070602Tiger Vision, LLC Silbernagel Jeffrey OD 10423 Old Hammond Hwy Baton Rouge LA 70816 19 05 1 none 1 2 1 30433546 91070602Tiger Vision, LLC Thomas Charles OD 10423 Old Hammond Hwy Baton Rouge LA 70816 28 88 1 none 1 2 1 30433546 91070602Tiger Vision, LLC Turia M. Theresa MD 10423 Old Hammond Hwy Baton Rouge LA 70816 20 18 1 none 1 2 2 30433546 91070602Tiger Vision, LLC Williamson Baron MD 10423 Old Hammond Hwy Baton Rouge LA 70816 20 18 1 none 1 2 2 30433546 91070602THE SCOOTER STORE - BATON ROUGE, LLC 10632 Alco Avenue Baton Rouge LA 70816 40 54 1 none 1 2 2 30409904 91062154THE PHYSICIAN'S ALLIANCE CORP (TPAC) Suico Valeriano 11281 Old Hammond Hwy Bldg A Baton Rouge LA 70816 35 65 1 none 1 2 2 30436836 91057760THAI ERIC N OD Thai Eric N. 11331 Old Hammond Hwy Ste B Baton Rouge LA 70816 28 88 1 none 1 2 2 30437040 91056963Sherwood Forest Medical Clinic Smith Christine MD 11548 Old Hammond Hwy Baton Rouge LA 70816 20 08 1 None 2 1 2 30437333 91054855


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

VITAL LINK, A HOME CARE COMPANY 11750 Bricksome Ave Suite B Baton Rouge LA 70816 44 75 1 none 1 2 2 30426275 91051178SMITH DANIEL B OD Smith Daniel 12333 Jefferson Hwy, Ste. I Baton Rouge LA 70816 28 88 1 none 1 2 1 30394975 91045962Burnham Family & Sports Medicine Anderson Derek MD 15165 S Harrell's Ferry Rd Baton Rouge LA 70816 20 08 1 None 2 1 2 30428078 91017937Burnham Family & Sports Medicine Ordeneaux Amy MD 15165 S Harrell's Ferry Rd Baton Rouge LA 70816 20 08 1 None 2 1 2 30428078 91017937Burnham Family & Sports Medicine Shaw Vincent MD 15165 S Harrell's Ferry Rd Baton Rouge LA 70816 20 08 1 None 2 1 2 30428078 91017937Ochsner Clinic Cauley M. Lynn 16777 Medical Center Dr. Baton Rouge LA 70816 28 88 1 none 1 2 2 30441500 91002838Ochsner Clinic Cauley Stephanie L. PT 16777 Medical Center Dr. Baton Rouge LA 70816 28 88 1 none 1 2 2 30441500 91002838Ochsner Clinic Creed J. Curtis 16777 Medical Center Dr. Baton Rouge LA 70816 20 18 1 none 1 2 2 30441500 91002838Ochsner Clinic Dauterive F. Ralph 16777 Medical Center Dr. Baton Rouge LA 70816 20 16 1 >=16 1 2 2 30441500 91002838Ochsner Clinic Durel Michael S. 16777 Medical Center Dr. Baton Rouge LA 70816 20 16 1 >=16 1 2 1 30441500 91002838Ochsner Clinic Erffmeyer John E. 16777 Medical Center Dr. Baton Rouge LA 70816 20 03 1 none 1 2 2 30441500 91002838Ochsner Clinic Fabrega Ruben D. 16777 Medical Center Dr. Baton Rouge LA 70816 20 2H 1 none 1 2 2 30441500 91002838Ochsner Clinic Fairley Thomas R. 16777 Medical Center Dr. Baton Rouge LA 70816 28 88 1 none 1 2 2 30441500 91002838Ochsner Clinic Flint Caroline F. 16777 Medical Center Dr. Suite 200 Baton Rouge LA 70816 20 41 1 >=18 1 2 2 30441500 91002838Ochsner Clinic Gaddis Kenneth A. 16777 Medical Center Dr. Baton Rouge LA 70816 20 13 1 none 1 2 2 30441500 91002838Ochsner Clinic Gesn Lois H. 16777 Medical Center Dr. Suite 200 Baton Rouge LA 70816 20 37 1 <=18 1 2 2 30441500 91002838Ochsner Clinic Golightly George 16777 Medical Center Dr. Baton Rouge LA 70816 20 02 1 none 1 2 2 30441500 91002838Ochsner Clinic Gomes Glenn M. 16777 Medical Center Dr. Baton Rouge LA 70816 20 29 1 none 1 2 2 30441500 91002838Ochsner Clinic Grenier Christopher P. 16777 Medical Center Dr. Baton Rouge LA 70816 20 18 1 none 1 2 2 30441500 91002838Ochsner Clinic Griffin Ewelina B. 16777 Medical Center Dr. Baton Rouge LA 70816 20 16 1 >=16 1 2 2 30441500 91002838Ochsner Clinic Hedges Sharon Y. 16777 Medical Center Dr. Baton Rouge LA 70816 20 16 1 >=16 1 2 2 30441500 91002838Ochsner Clinic Hernandez Lincoln 16777 Medical Center Dr. Baton Rouge LA 70816 20 10 1 none 1 2 2 30441500 91002838Ochsner Clinic Holmes Keith A. 16777 Medical Center Dr. Suite 200 Baton Rouge LA 70816 20 41 1 >=18 1 2 2 30441500 91002838Ochsner Clinic Howard George W. 16777 Medical Center Dr. Baton Rouge LA 70816 20 10 1 none 1 2 2 30441500 91002838Ochsner Clinic Huynh Trang P. 16777 Medical Center Dr. Baton Rouge LA 70816 20 16 1 >=16 1 2 2 30441500 91002838Ochsner Clinic Jeansonne Louis O. 16777 Medical Center Dr. Baton Rouge LA 70816 20 02 1 none 1 2 2 30441500 91002838Ochsner Clinic Jo Jeannie Y. 16777 Medical Center Dr. Baton Rouge LA 70816 32 48 1 none 1 2 2 30441500 91002838Ochsner Clinic Jones Brian P. 16777 Medical Center Dr. Baton Rouge LA 70816 20 06 1 none 1 2 2 30441500 91002838Ochsner Clinic Kamyar Amin 16777 Medical Center Dr. Baton Rouge LA 70816 20 2K 1 none 1 2 2 30441500 91002838Ochsner Clinic Khan Abdul B. 16777 Medical Center Dr. Baton Rouge LA 70816 20 13 1 none 1 2 2 30441500 91002838Ochsner Clinic Khuri Bahij N. 16777 Medical Center Dr. Baton Rouge LA 70816 20 06 1 none 1 2 2 30441500 91002838Ochsner Clinic Kindl Brian T. 16777 Medical Center Dr. Baton Rouge LA 70816 20 20 1 none 1 2 2 30441500 91002838Ochsner Clinic King Teresa L. 16777 Medical Center Dr. Baton Rouge LA 70816 20 04 1 none 1 2 2 30441500 91002838Ochsner Clinic Longe Ade C. 16777 Medical Center Dr. Baton Rouge LA 70816 20 13 1 none 1 2 2 30441500 91002838Ochsner Clinic McGrath Stephanie J. 16777 Medical Center Dr. Baton Rouge LA 70816 20 29 1 none 1 2 2 30441500 91002838Ochsner Clinic McKinney, II R. Dale 16777 Medical Center Dr. Suite 200 Baton Rouge LA 70816 20 41 1 >=18 1 2 2 30441500 91002838Ochsner Clinic McKnight Melanie J. PT 16777 Medical Center Dr. Baton Rouge LA 70816 20 2K 1 none 1 2 2 30441500 91002838Ochsner Clinic Morgan Michael G. 16777 Medical Center Dr. Baton Rouge LA 70816 20 18 1 none 1 2 2 30441500 91002838Ochsner Clinic Morvant Kristin W. 16777 Medical Center Dr. Baton Rouge LA 70816 20 08 1 None 1 2 2 30441500 91002838Ochsner Clinic Moussa Khalid M. 16777 Medical Center Dr. Baton Rouge LA 70816 20 10 1 none 1 2 2 30441500 91002838Ochsner Clinic Narang Jhumka Ghosh 16777 Medical Center Dr. Baton Rouge LA 70816 20 2K 1 none 1 2 2 30441500 91002838Ochsner Clinic Payne Thomas N. 16777 Medical Center Dr. Baton Rouge LA 70816 20 16 1 >=16 1 2 1 30441500 91002838Ochsner Clinic Prempeh Osei B. 16777 Medical Center Dr. Baton Rouge LA 70816 20 08 1 None 1 2 2 30441500 91002838Ochsner Clinic Rabalais Amy G. 16777 Medical Center Dr. Suite 200 Baton Rouge LA 70816 20 04 1 none 1 2 2 30441500 91002838Ochsner Clinic Russo Aldo J. 16777 Medical Center Dr. Baton Rouge LA 70816 20 10 1 none 1 2 2 30441500 91002838Ochsner Clinic Sharon Marius S. 16777 Medical Center Dr. Baton Rouge LA 70816 20 06 1 none 1 2 2 30441500 91002838Ochsner Clinic Shingleton William B. 16777 Medical Center Dr. Baton Rouge LA 70816 20 34 1 none 1 2 2 30441500 91002838Ochsner Clinic Tellis Claude J. 16777 Medical Center Dr. Baton Rouge LA 70816 20 29 1 none 1 2 2 30441500 91002838Ochsner Clinic Velazquez Salvador 16777 Medical Center Dr. Baton Rouge LA 70816 20 06 1 none 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Montelaro James S. 16777 Medical Ctr Dr Suite 125 Baton Rouge LA 70816 20 04 1 none 1 2 2 30441500 91002838


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vuong Hieu Tu 16777 Medical Ctr Dr Suite 400 Baton Rouge LA 70816 32 48 1 none 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pino Lannie B. 16777 Medical Ctr Dr Ste 400 Baton Rouge LA 70816 78 08 1 None 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stryjewska Barbara 16777 Medical Ctr Dr, Ste 125 Baton Rouge LA 70816 20 08 1 None 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 30 1 none 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ahmad Iqbal 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 06 1 none 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bankston Cecil 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 30 1 none 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barai Lalit 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 41 1 >=18 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Doll N. James 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 03 1 none 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dupre Michael 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 02 1 none 1 2 1 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Girgis Salwa 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 41 1 >=18 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guarisco Michael 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 41 1 >=18 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gupta Alok 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 41 1 >=18 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mcintyre John 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 16 1 >=16 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Moreno Mario 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 08 1 None 1 2 2 30441500 91002838THE PHYSICIAN'S ALLIANCE CORP (TPAC) Safford Noemie 16777 Medical Ctr Dr, Ste 400 Baton Rouge LA 70816 20 41 1 >=18 1 2 2 30441500 91002838Ochsner Medical Center Baton Rouge 1700 Medical Center Drive Baton Rouge LA 70816 60 86 1 none 1 2 2 30442400 91000700Ochsner Clinic Brewer Dana 17000 Medical Center Drive Baton Rouge LA 70816 78 16 1 >=16 1 2 2 30441248 90999810Ochsner Clinic Hayden Dorothy V. 17000 Medical Center Drive Baton Rouge LA 70816 20 22 1 none 1 2 2 30441248 90999810Ochsner Clinic Murray Rebecca A. 17000 Medical Center Drive Baton Rouge LA 70816 20 22 1 none 1 2 2 30441248 90999810Ochsner Clinic Pei Leo A. 17000 Medical Center Drive Baton Rouge LA 70816 20 22 1 none 1 2 2 30441248 90999810Urgent Care & Family Med Clinic Wahid Saiyid R MD 1962 O'Neal Lane Ste H-1 Baton Rouge LA 70816 20 41 1 >=18 1 2 2 30440238 91007992THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brandt Gary 2380 Oneal Lane Suite A Baton Rouge LA 70816 20 08 1 none 1 2 2 30434403 91007716THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lemelle Tracy 2380 Oneal Lane Suite A Baton Rouge LA 70816 20 41 1 >=18 1 2 2 30434403 91007716Dr Phuong T Dinh Dinh Phuong T OD 2515 O'Neal Lane Ste 5 Baton Rouge LA 70816 28 88 1 >=4 2 1 2 30430628 91007377THE PHYSICIAN'S ALLIANCE CORP (TPAC) Buller Myra 2645 Oneal Lane, Bldg. C Suite D Baton Rouge LA 70816 35 65 1 none 1 2 2 30429223 91007377THE PHYSICIAN'S ALLIANCE CORP (TPAC) Levins Stephen 2645 Oneal Lane, Bldg. C Suite D Baton Rouge LA 70816 35 65 1 none 1 2 2 30429223 91007377THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mackay Lorrain 2645 Oneal Lane, Bldg. C Suite D Baton Rouge LA 70816 35 65 1 none 1 2 2 30429223 91007377THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ward Gregory 3535 S Sherwood Forest Blvd Suite 247 Baton Rouge LA 70816 35 65 1 none 1 2 1 30420706 91051312THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vuong Hieu Tu 3851 S Sherwood Forest #360 Baton Rouge LA 70816 32 48 1 none 1 2 2 30417939 91051313The Vision Center Carnaggio Carl J OD 4615 S Sherwood Forest Baton Rouge LA 70816 28 88 1 None 1 2 2 30412281 91051282CARNAGGIO CARL Jr., OD Carnaggio Jr Carl (Joey) OD 4615 S. Sherwood Forest Baton Rouge LA 70816 28 88 1 none 1 2 1 30412281 91051282RIGHT CHOICE MEDICAL SUPPLIES 5525 Galeria Dr. Ste F Baton Rouge LA 70816 40 54 1 none 1 2 2 30404973 91050027Footsteps LLC Formanek Christopher DPM 6141 Parkforest Dr Baton Rouge LA 70816 20 48 1 None 1 2 2 30395534 91044784THE PHYSICIAN'S ALLIANCE CORP (TPAC) Formanek Christopher 6141 Parkforest Drive Baton Rouge LA 70816 32 48 1 none 1 2 2 30395534 91044784OCHSNER DURABLE MEDICAL EQUIPMENT 13711 Coursey Blvd, Ste. C Baton Rouge LA 70817 40 54 1 none 1 2 2 30408319 91026312THE PHYSICIAN'S ALLIANCE CORP (TPAC) Day Michael G. 13828 Coursey Blvd Baton Rouge LA 70817 20 08 1 None 1 2 2 30407969 91024282THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ferrara Gregory F. 13828 Coursey Blvd Baton Rouge LA 70817 20 08 1 None 1 2 2 30407969 91024282THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Christopher 13828 Coursey Blvd Baton Rouge LA 70817 20 08 1 None 1 2 2 30407969 91024282Eye Medical Center Wood Jeremy MD 14241 Coursey Blvd Ste A8 Baton Rouge LA 70817 20 18 1 None 2 1 2 30408410 91019631Moreau Physical Therapy Bozant Ryan 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128Moreau Physical Therapy Chamberlain Jerry 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128Moreau Physical Therapy Faucheux Christina 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128Moreau Physical Therapy Giles Robin 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128Moreau Physical Therapy Grunewald Kristopher 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128Moreau Physical Therapy Jones Althea 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128Moreau Physical Therapy LeBlanc Kyle 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128Moreau Physical Therapy Martin Murphy Jude 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128Moreau Physical Therapy Moreau, III Alvin C. 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 1 30361985 91000128Moreau Physical Therapy Moreau, Jr Al C. 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128Moreau Physical Therapy Pavy Mary Katherine 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128


LOI Contract STP*

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Age Restricti

onPCP Link

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Moreau Physical Therapy Williams Kara 17301 Jefferson Hwy, Ste 3 Baton Rouge LA 70817 35 65 1 none 1 2 2 30361985 91000128Urgent Care & Family Med Clinic Wahid Saiyid R MD 4802 Jones Creek Baton Rouge LA 70817 20 41 1 >=18 1 2 2 30409984 91015992PAYLESS OPTICAL OUTLET 5368 Kennesaw Dr Baton Rouge LA 70817 28 88 1 none 1 2 1 30402163 91001389THE PHYSICIAN'S ALLIANCE CORP (TPAC) Comeaux Sacha 7116 Antioch Rd Baton Rouge LA 70817 35 65 1 none 1 2 2 30386860 91007538THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guitrau Jill 7116 Antioch Rd Baton Rouge LA 70817 35 65 1 none 1 2 2 30386860 91007538THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mayers Chad PT 7116 Antioch Rd Baton Rouge LA 70817 35 65 1 none 1 2 2 30386860 91007538THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morgan Michael 7116 Antioch Rd Baton Rouge LA 70817 35 65 1 none 1 2 2 30386860 91007538THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dial Daniel 10880 Joor Rd Baton Rouge LA 70818 20 41 1 >=18 1 2 2 30546067 91053360THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 11055 Shoe Creek Drive Lake After Hours Baton Rouge LA 70818 20 03 1 none 1 2 2 30550607 91044044THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 11055 Shoe Creek Drive Lake After Hours Baton Rouge LA 70818 20 08 1 none 1 2 2 30550607 91044044THE PHYSICIAN'S ALLIANCE CORP (TPAC) Lee Yushen 11055 Shoe Creek Drive Lake After Hours Baton Rouge LA 70818 20 41 1 >=18 1 2 2 30550607 91044044Eye Medical Center Fargason David P MD 11424 Sullivan Rd Bldg A Ste A Baton Rouge LA 70818 20 18 1 None 2 1 2 30552171 91035060Eye Medical Center Wood Jeremy MD 11424 Sullivan Rd Bldg A Ste A Baton Rouge LA 70818 20 18 1 None 1 2 2 30552171 91035060Moreau Physical Therapy Bozant Ryan 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060Moreau Physical Therapy Chamberlain Jerry 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060Moreau Physical Therapy Faucheux Christina 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060Moreau Physical Therapy Giles Robin 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060Moreau Physical Therapy Grunewald Kristopher 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060Moreau Physical Therapy Jones Althea 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060Moreau Physical Therapy LeBlanc Kyle 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060Moreau Physical Therapy Martin Murphy Jude 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060Moreau Physical Therapy Moreau, III Alvin C. 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 1 30552171 91035060Moreau Physical Therapy Moreau, Jr Al C. 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060Moreau Physical Therapy Pavy Mary Katherine 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060Moreau Physical Therapy Williams Kara 11424 Sullivan Rd Bldg C Ste A Baton Rouge LA 70818 35 65 1 none 1 2 2 30552171 91035060CENTRAL IMAGING CENTER 11424 Sullivan Rd. Bldg. B, Suite C Baton Rouge LA 70818 20 30 1 none 1 2 1 30552171 91035060Ochsner Clinic Holmes Keith A. 11424 Sullivan Rd. Suite B1 Baton Rouge LA 70818 20 41 1 >=18 1 2 2 30552171 91035060Ochsner Clinic Velazquez Salvador 11424 Sullivan Rd. Suite B1 Baton Rouge LA 70818 20 06 1 none 1 2 2 30552171 91035060THE PHYSICIAN'S ALLIANCE CORP (TPAC) Azmeh Waref 4890 Bluebonnet Blvd., B Baton Rouge LA 70821 20 2I 1 none 1 2 2 30448350 91183400RICHARDSON MEDICAL CENTER Lewis Matthew J. JSM Anesthesia Baton Rouge LA 70879 91 05 1 none 1 2 2 30409717 91032384PRECISION RADIOLOGY MANAGEMENT 1175 Pine St Ste 200 Arcadia LA 71001 20 30 1 none 1 2 2 32554098 92914525BIENVILLE MEDICAL CENTER 1175 Pine Street Suite 200 Arcadia LA 71001 60 86 1 none 1 2 2 32554098 92914525RUSTON CLINIC COMPANY LLC Nishat Arifa MD 1251 Hazel Street Arcadia LA 71001 20 08 1 None 1 2 2 32559215 92913539RUSTON CLINIC COMPANY LLC Williams Angela FNP 1251 Hazel Street Arcadia LA 71001 78 08 1 >=18 1 2 2 32559215 92913539CHRISTUS HEALTH CENTRAL LA 1635 Marvel Street Coushatta LA 71019 60 86 1 none 1 2 1 32022184 93343174ADVANTAGE HOME HEALTH CARE IN 1810 Front Street Coushatta LA 71019 40 54 1 none 1 2 2 32020673 93344862THOMAS DURWARD J OD Thomas Durward J. OD 1902 Ringgold Ave Coushatta LA 71019 28 88 1 none 1 2 2 32018039 93344655SYNERGY HOME CARE-NORTHWESTERN REGION, INC 622 Rush St Coushatta LA 71019 44 75 1 none 1 2 2 32025186 93346440DAVID RAINES COMM HEALTH CENTER 12763 Lay Street Gilliam LA 71029 72 9L 1 none 1 2 2 32826495 93845813DAVID RAINES COMM HEALTH CENTER Miller Angela FNP 12763 Lay Street Gilliam LA 71029 78 08 1 None 1 2 1 32826495 93845813HIGHLAND CLINIC Taylor N. Scott 954 Hwy 80 Suite 100 Haughton LA 71037 28 88 1 none 1 2 2 32556600 93555700DAVID RAINES COMM HEALTH CENTER 1953 East Main Street Haynesville LA 71038 72 9L 1 none 1 2 2 32961908 93138320DAVID RAINES COMM HEALTH CENTER Jackson Lou Ella FNP 1953 East Main Street Haynesville LA 71038 78 08 1 None 1 2 2 32961908 93138320BUTLER - ABSHIRE RURAL HEALTH CLINIC Abshire Samuel K. MD 926 Frances Dr. Haynesville LA 71038 20 08 1 none 1 2 2 32952116 93123151BUTLER - ABSHIRE RURAL HEALTH CLINIC Baggett-Woodard Debra FNP 926 Frances Dr. Haynesville LA 71038 78 08 1 none 1 2 2 32952116 93123151BUTLER - ABSHIRE RURAL HEALTH CLINIC Butler Clint C. 926 Frances Dr. Haynesville LA 71038 20 08 1 none 1 2 1 32952116 93123151BUTLER - ABSHIRE RURAL HEALTH CLINIC 926 Frances Drive Haynesville LA 71038 79 94 1 none 1 2 2 32952116 93123151FAMILY MEDICAL CLINIC OF HOMER, INC 104 Morris Circle Homer LA 71040 20 08 1 None 1 2 1 32813155 93055750FAMILY MEDICAL CLINIC OF HOMER, INC Cardin Joan P. FNPC 104 Morris Circle Homer LA 71040 78 08 1 none 1 2 1 32813155 93055750FAMILY MEDICAL CLINIC OF HOMER, INC Salmon Clifton W. MD 104 Morris Circle Homer LA 71040 20 08 1 none 1 2 1 32813155 93055750


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

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Postal Code

HIGHLAND CLINIC Walker Donna A. MD 620 E. College Street Suite D Homer LA 71040 20 2H 1 none 1 2 1 32792611 93062641RUSTON CLINIC COMPANY LLC Meyer Kevin MD 620 East College Street Homer LA 71040 20 02 1 none 1 2 2 32792611 93062641RUSTON CLINIC COMPANY LLC Murray Howard N. MD 620 East College Street Homer LA 71040 20 29 1 none 1 2 2 32792611 93062641CLAIBORNE FAMILY MEDICAL CLINIC Haynes Donald K. MD 912 West Main Homer LA 71040 20 08 1 none 1 2 1 32800013 93055737CLAIBORNE FAMILY MEDICAL CLINIC Haynes Scott D. MD 912 West Main Homer LA 71040 20 41 1 >=18 1 2 1 32800013 93055737CLAIBORNE FAMILY MEDICAL CLINIC Haynes Wm. Mark MD 912 West Main Homer LA 71040 20 08 1 none 1 2 1 32800013 93055737CLAIBORNE FAMILY MEDICAL CLINIC Rains Katherine ACNP 912 West Main Homer LA 71040 78 79 1 >=18 1 2 2 32800013 93055737CASSE COMMUNITY HEALTH INSTITUTE 907 Polk Street Mansfield LA 71052 79 94 1 none 1 2 2 32037822 93702039CASSE COMMUNITY HEALTH INSTITUTE Combs S. Bewell 907 Polk Street Mansfield LA 71052 20 41 1 >=18 1 2 2 32037822 93702039CASSE COMMUNITY HEALTH INSTITUTE Hathorn Alfred MD 907 Polk Street Mansfield LA 71052 20 37 1 none 1 2 1 32037822 93702039CASSE COMMUNITY HEALTH INSTITUTE Sawyer Douglas 907 Polk Street Mansfield LA 71052 20 02 1 none 1 2 2 32037822 93702039HIGHLAND CLINIC Walker Donna A. MD #3 medical Plaza Minden LA 71055 20 2H 1 none 1 2 1 32616866 93285377MINDEN MEDICAL CENTER 1 Medical Plaza Pl Minden LA 71055 60 86 1 none 1 2 2 32616858 93285374STELL FAMILY PRACTICE Stell Gerald M. 102 Office Park Drive Minden LA 71055 20 08 1 none 1 2 1 32623500 93258400MINDEN HOME CARE EQUIPMENT/UN 106 Ryans Way Minden LA 71055 40 54 1 none 1 2 2 32586100 93259400FAMILY MEDICINE ASSOC 1111 Homer Rd Minden LA 71055 78 08 1 none 1 2 2 32623468 93256632Trinity Home Care Inc. 114 West Union Street Minden LA 71055 20 37 1 none 1 2 2 32615712 93286891DAVID RAINES COMM HEALTH CENTER 128 Homer Road Minden LA 71055 72 9L 1 none 1 2 2 32621248 93279464DAVID RAINES COMM HEALTH CENTER Jackson Lou Ella FNP 128 Homer Road Minden LA 71055 78 08 1 None 1 2 2 32621248 93279464DAVID RAINES COMM HEALTH CENTER Koduru Suneetha MD 128 Homer Road Minden LA 71055 20 08 1 None 1 2 2 32621248 93279464DAVID RAINES COMM HEALTH CENTER Pratibha Anne MD 128 Homer Road Minden LA 71055 20 08 1 None 1 2 2 32621248 93279464

Fleming John C. MD 208 Morris Dr Minden LA 71055 20 08 1 none 1 2 2 32622764 93261697

Pistorius Michael MD 208 Morris Dr Minden LA 71055 20 08 1 none 1 2 2 32622764 93261697MINDEN FAMILY CARE CENTER Fleming John C. MD 208 Morris Dr. Minden LA 71055 20 08 1 none 1 2 2 32622764 93261697MINDEN FAMILY CARE CENTER Pistorius Michael MD 208 Morris Dr. Minden LA 71055 20 08 1 none 1 2 2 32622764 93261697

208 Morris Drive Minden LA 71055 79 94 1 none 1 2 2 32622764 93261697DERRELL R. SPURLOCK II, O.D. Spurlock, II Derrell R. 421 Homer Rd. Minden LA 71055 28 88 1 none 1 2 1 32621407 93272682MOSS EDWIN B OD Moss Edwin B. 800 Main St Minden LA 71055 28 88 1 none 1 2 1 32619636 93282081NORTH CADDO HOSPITAL 108 North Louisiana Plain Dealing LA 71064 79 94 1 none 1 2 1 32906715 93704879NORTH CADDO HOSPITAL McCommon Nicole MD 108 North Louisiana Plain Dealing LA 71064 20 08 1 none 1 2 1 32906715 93704879NORTH CADDO HOSPITAL Richardson Kathleen FNP 108 North Louisiana Plain Dealing LA 71064 78 08 1 none 1 2 1 32906715 93704879THOMAS DURWARD J OD Thomas Durward J. OD 227 Military Hwy Ringgold LA 71068 28 88 1 none 1 2 2 32277602 93279333SPRINGHILL MEDICAL CENTER Franks Kristen P. APRN 106 Tri-State Drive North Webster Clinic Sarepta LA 71071 78 08 1 none 1 2 2 32955673 93456561SPRINGHILL MEDICAL CENTER Smith Marla K. PA 106 Tri-State Drive Serapeta LA 71071 20 08 1 none 1 2 1 32955673 93456561HIGHLAND CLINIC Henderson Bruce C. MD 1108 Doctors Drive Springhill LA 71075 20 18 1 none 1 2 2 33011489 93445383HIGHLAND CLINIC Taylor N. Scott 1108 Doctors Drive Springhill LA 71075 28 88 1 none 1 2 2 33011489 93445383SPRINGHILL MEDICAL CENTER Torrence Leamon G. MD 2001 Doctor Drive Springhill LA 71075 20 08 1 none 1 2 2 33011197 93442871HIGHLAND CLINIC Walker Donna A. MD 2001 Doctor Drive Springhill LA 71075 20 2H 1 none 1 2 1 33011197 93442871SPRINGHILL MEDICAL CENTER 2001 Doctors Drive Springhill LA 71075 60 86 1 none 1 2 2 33011197 93442871SPRINGHILL MEDICAL CENTER Bozeman Martin C. MD 2001 Doctors Drive Springhill Medical Ce Springhill LA 71075 20 02 1 none 1 2 2 33011197 93442871SPRINGHILL MEDICAL CENTER Cassidy Tommie A. APRN 2001 Doctors Drive SMC/Doctors Clinic Springhill LA 71075 78 08 1 none 1 2 1 33011197 93442871SPRINGHILL MEDICAL CENTER Heise Brian A. MD 2001 Doctors Drive Springhill LA 71075 20 08 1 none 1 2 2 33011197 93442871SPRINGHILL MEDICAL CENTER Law David W. MD 2001 Doctors Drive Springhill LA 71075 20 08 1 none 1 2 1 33011197 93442871SPRINGHILL MEDICAL CENTER Pair Kimberly D. PA 2001 Doctors Drive Springhill LA 71075 20 08 1 none 1 2 2 33011197 93442871SPRINGHILL MEDICAL CENTER Pardue Michelle L. MD 2001 Doctors Drive Springhill LA 71075 20 08 1 none 1 2 1 33011197 93442871SPRINGHILL MEDICAL CENTER Sessions Jerry W. MD 2001 Doctors Drive Springhill LA 71075 20 08 1 none 1 2 2 33011197 93442871SPRINGHILL MEDICAL CENTER 401 11th N.E. Springhill LA 71075 79 94 1 none 1 2 1 33004709 93445878

Park City Health Services dba Minden Family Care Center




LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

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Postal Code

SPRINGHILL MEDICAL CENTER Heise Brian A. MD 401 11th N.E. Springhill LA 71075 20 08 1 none 1 2 2 33004709 93445878SPRINGHILL MEDICAL CENTER Holladay Samuel S. MD 401 11th N.E. Springhill LA 71075 20 08 1 none 1 2 1 33004709 93445878SPRINGHILL MEDICAL CENTER Law David W. MD 401 11th N.E. Springhill LA 71075 20 08 1 none 1 2 1 33004709 93445878SPRINGHILL MEDICAL CENTER Pair Kimberly D. PA 401 11th N.E. Springhill LA 71075 20 08 1 none 1 2 2 33004709 93445878SPRINGHILL MEDICAL CENTER Pardue Michelle L. MD 401 11th N.E. Springhill LA 71075 20 08 1 none 1 2 1 33004709 93445878SPRINGHILL MEDICAL CENTER Sessions Jerry W. MD 401 11th N.E. Springhill LA 71075 20 08 1 none 1 2 2 33004709 93445878SPRINGHILL MEDICAL CENTER Torrence Leamon G. MD 401 11th N.E. Springhill LA 71075 20 08 1 none 1 2 2 33004709 93445878NORTH CADDO HOSPITAL 1000 South Spruce Street Vivian LA 71082 60 86 1 none 1 2 2 32863647 93989761NORTH CADDO HOSPITAL McCommon Nicole MD 1003 South Spruce Vivian LA 71082 20 08 1 none 1 2 1 32863637 93989435NORTH CADDO HOSPITAL 1003 South Spruce St. Vivian LA 71082 79 94 1 none 1 2 1 32863637 93989435NORTH CADDO HOSPITAL Chance Jody D. MD 1003 South Spruce Street Vivian LA 71082 20 08 1 none 1 2 1 32863637 93989435NORTH CADDO HOSPITAL Haynes, Jr. John H. MD 1003 South Spruce Street Vivian LA 71082 20 08 1 None 1 2 2 32863637 93989435NORTH CADDO HOSPITAL Landreneau Sean FNA 1003 South Spruce Street Vivian LA 71082 78 08 1 none 1 2 1 32863637 93989435NORTH CADDO HOSPITAL Lococco Vincent MD 1003 South Spruce Street Vivian LA 71082 20 08 1 none 1 2 1 32863637 93989435NORTH CADDO HOSPITAL Taylor Stephen G. MD 1003 South Spruce Street Vivian LA 71082 20 08 1 none 1 2 1 32863637 93989435CHARLES D. SHANKS, O.D. Shanks Charles D. 101 E. Louisiana St. Vivian LA 71082 28 88 1 none 1 2 2 32872320 93986489HIGHLAND CLINIC Berg M. Ellen MD 101 East Louisiana Vivian LA 71082 20 18 1 none 1 2 2 32872320 93986489RADIOLOGY IMAGING ASSOC-LLP Grozinger Kurt T. MD 1500 Line Ave Shreveport LA 71101 20 30 1 none 1 2 1 32498050 93746270ALLEGIANCE MEDICAL SUPPLY 1532 Irving Place Shreveport LA 71101 40 54 1 none 1 2 2 32497763 93744661SREEDEVI YERRAPRAGGADA Yerrapragada Sreedvi 1534 Elizabeth Ave Shreveport LA 71101 20 41 1 >=18 1 2 2 32497741 93747670TOM P. SENFF, M.D. APMC Senff Tom P. 1534 Elizabeth Ave. Shreveport LA 71101 20 41 1 >=18 1 2 2 32497741 93747670CHARLES P. WERNER, M.D. APMC Werner Charles P. 1534 Elizabeth Ave. Shreveport LA 71101 20 41 1 >=18 1 2 1 32497741 93747670C. H. Wilkinson Physican Network Coleman Stephen C. CDO 1534 Elizabeth Street Suite 202 Shreveport LA 71101 19 16 1 >=16 1 2 1 32497741 93747670C. H. Wilkinson Physican Network Jones Joe S. MD 1534 Elizabeth Street Suite 204 Shreveport LA 71101 20 16 1 >=16 1 2 1 32497741 93747670C. H. Wilkinson Physican Network Pharr Julie H. NP 1534 Elizabeth Street Suite 202 Shreveport LA 71101 78 79 1 >=18 1 2 2 32497741 93747670C. H. Wilkinson Physican Network Talukder Saimah MD 1534 Elizabeth Street Suite 202 Shreveport LA 71101 20 16 1 >=16 1 2 1 32497741 93747670CARMODY JOHN B MD Carmody John B. MD 1801 Fairfield Ave Ste 103 Shreveport LA 71101 20 18 1 none 1 2 2 32494349 93752208STEPHANIE HENSON MD Henson Stephanie MD 1801 Fairfield Ave Ste 201 Shreveport LA 71101 19 37 1 <=18 1 2 1 32494349 93752208SUSAN E KEMP MD LLC Kemp Susan E. MD 1801 Fairfield Ave Ste 304 Shreveport LA 71101 20 41 1 >=18 1 2 2 32494349 93752208C. H. Wilkinson Physican Network Runnels Lauren MD 1801 Fairfield Ave Suite 401 Shreveport LA 71101 20 16 1 >=16 1 2 1 32494349 93752208C. H. Wilkinson Physican Network Sataluri Sesha MD 1801 Fairfield Ave Suite 400 Shreveport LA 71101 20 41 1 >=18 1 2 1 32494349 93752208C. H. Wilkinson Physican Network Underwood John MD 1801 Fairfield Ave Suite 400 Shreveport LA 71101 20 41 1 >=18 1 2 2 32494349 93752208C. H. Wilkinson Physican Network Wadyal Crystal J. MD 1801 Fairfield Ave Suite 401 Shreveport LA 71101 20 16 1 >=16 1 2 2 32494349 93752208C. H. Wilkinson Physican Network Whitaker Racheal MD 1801 Fairfield Ave Suite 401 Shreveport LA 71101 20 16 1 >=16 1 2 1 32494349 93752208COURTNEY III JENNESS D MD Courtney, III Jenness D. 1801 Fairfield Avenue Ste 411 Shreveport LA 71101 35 65 1 none 1 2 2 32494349 93752208OMEGA DIAGNOSTICS, LLC 1st Mary Place Shreveport LA 71101 20 30 1 none 1 2 1 32494427 93724106Quest Diagnostics 820 Jordan Ste 102 Shreveport LA 71101 20 30 1 none 1 1 2 32498318 93746678C. H. Wilkinson Physican Network Agnani Sujata T. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Aura A. Michael MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Bahadur Shakeela W. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Bhanderi Vipul K. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Boyd Molly L. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Brown Mark F. MD One Saint Mary Place Shreveport LA 71101 20 1P 1 none 1 2 1 32494838 93750659C. H. Wilkinson Physican Network Caldwell Rosaline M. NP One Saint Mary Place Shreveport LA 71101 78 08 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Carlisle Kelly M. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Chauvin Ryan N. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Cheema Faisal N. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Desalu Olabode O. MD One Saint Mary Place Shreveport LA 71101 20 37 1 <=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Edelman Samuel B. DO One Saint Mary Place Shreveport LA 71101 19 37 1 <=18 1 2 1 32494838 93750659C. H. Wilkinson Physican Network Heinrich Penny L. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

C. H. Wilkinson Physican Network Kampert Amanda L. MD One Saint Mary Place Shreveport LA 71101 20 37 1 <=18 1 2 1 32494838 93750659C. H. Wilkinson Physican Network Kemp Susan E. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Kendrick Terry W. MD One Saint Mary Place Shreveport LA 71101 20 37 1 <=18 1 2 1 32494838 93750659C. H. Wilkinson Physican Network Kiser Henry J. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Maxwell Stephen R. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Mekelburg Kenneth J. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Michael Richard J. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Nair Binu S. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Pumphrey Heith E. NP One Saint Mary Place Shreveport LA 71101 78 08 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Roohani Peyman MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Roques-Davies Rebecca MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Shafton Eugene P. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Singh Mandeep MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Sorrells Donald L. MD One Saint Mary Place Shreveport LA 71101 20 1P 1 none 1 2 1 32494838 93750659C. H. Wilkinson Physican Network Stephens, Jr. Johnny J. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Trawick Thomas S. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Turpen Judith L. NP One Saint Mary Place Shreveport LA 71101 78 08 1 >=18 1 2 2 32494838 93750659C. H. Wilkinson Physican Network Volodin Leonid N. MD One Saint Mary Place Shreveport LA 71101 20 41 1 >=18 1 2 2 32494838 93750659CHRISTUS HEALTH NORTHERN LA One St. Mary Place Shreveport LA 71101 60 86 1 none 1 2 1 32501092 93738227NORWOOD SURGICAL SPECIALISTS Norwood William L. MD 2751 Albert L. Bicknell Dr Ste 3A Shreveport LA 71103 20 02 1 >=18 1 2 2 32485513 93778502NORWOOD SURGICAL SPECIALISTS Burke James B. 2751 Albert L. Bicknell Dr. Ste 3A Shreveport LA 71103 20 02 1 >=18 1 2 2 32485513 93778502RAMOS MARCO A MD Ramos Marco A. MD 2800 Hearne Ave Shreveport LA 71103 20 14 1 none 1 2 2 32485333 93780452THE PHYSICIAN'S ALLIANCE CORP (TPAC) Caradonna Lindsay 2820 Hearne Avenue Shreveport LA 71103 35 65 1 none 1 2 2 32485201 93780453THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hart Timothy 2820 Hearne Avenue Shreveport LA 71103 35 65 1 none 1 2 2 32485201 93780453RADIOLOGY IMAGING ASSOC-LLP Grozinger Kurt T. MD 2900 Hearne Ave Shreveport LA 71103 20 30 1 none 1 2 1 32484413 93780461CERTIFIED LIMB & BRACE Richter Henry 3227 Portland Ave Shreveport LA 71103 40 53 1 none 1 2 2 32484330 93776791BALENTINE AMBUL SERVICE INC 3516 Mansfield Rd. Shreveport LA 71103 51 59 1 none 1 2 2 32478009 93772672BAKOWSKI GEORGE OD APC Bakowski George 1133 St. Vincent Ave Ste 120, Box 216 Shreveport LA 71104 28 88 1 none 1 2 1 32479465 93748191CHARLES D. SHANKS, O.D. Shanks Charles D. 1133 St. Vincent Ave #34 Shreveport LA 71104 28 88 1 none 1 2 2 32490715 93721578THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brewer Adam 2015 Fairfield Avenue 2-b Shreveport LA 71104 35 65 1 none 1 2 2 32492562 93751111THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brewer Amanda 2015 Fairfield Avenue 2-b Shreveport LA 71104 35 65 1 none 1 2 2 32492562 93751111LIFEQUEST MEDICAL SUPPLY LLC 2038 Line Ave Shreveport LA 71104 40 54 1 none 1 2 2 32491977 93746208ARK LA TEX MEDICAL SERVICES 3825 Gibert Dr. Ste 142 Shreveport LA 71104 40 54 1 none 1 2 2 32490852 93721922IN HOME RESPIRATORY LLC Rossi David R. 3825 Gilbert Drive Suite 123 Shreveport LA 71104 40 54 1 none 1 2 2 32471926 93737150Trinity Home Care Inc. 3825 Gilbert Street Suite 101 Shreveport LA 71104 20 37 1 none 1 2 2 32471926 93737150NEPHROLOGY CONSULTANTS LLC Kilpatrick John Stephen MD 745 Olive Street Ste 200 Shreveport LA 71104 20 2K 1 none 1 2 2 32492549 93745212NEPHROLOGY CONSULTANTS LLC White Randall Glen MD 745 Olive Street Ste 200 Shreveport LA 71104 20 2K 1 none 1 2 2 32492549 93745212BHARTI M. MANCHANDIA, MD Manchandia Bharti M. MD 870 Olive St Shreveport LA 71104 20 37 1 <=18 1 2 1 32492820 93748447SOUTH SHREVEPORT FAMILY MEDICINE, LLC Barnes Jon C. FNP 1400 E. Bert Kouns, #104 Shreveport LA 71105 78 08 1 None 1 2 1 32423824 93720179SOUTH SHREVEPORT FAMILY MEDICINE, LLC Zando Iram K. MD 1400 E. Bert Kouns, #104 Shreveport LA 71105 20 08 1 none 1 2 1 32423824 93720179HIGHLAND CLINIC Coburn Amy E. OD 1400 East Bert Kouns Suite 103 Shreveport LA 71105 28 88 1 none 1 2 2 32423824 93720179HIGHLAND CLINIC Hinrichsen John D. MD 1400 East Bert Kouns Suite 103 Shreveport LA 71105 20 18 1 none 1 2 1 32423824 93720179HIGHLAND CLINIC Richards Alan B. MD 1400 East Bert Kouns Suite 103 Shreveport LA 71105 20 18 1 none 1 2 1 32423824 93720179SHREVEPORT PHYSICAL THERAPY & SPORTS MEDICINE Arcement Corey P. PT, DPT, OCS1453 East Bert Kouns Shreveport LA 71105 35 65 1 none 1 2 2 32424669 93719442SHREVEPORT PHYSICAL THERAPY & SPORTS MEDICINE Cowley Charles M. PT 1453 East Bert Kouns Shreveport LA 71105 35 65 1 none 1 2 2 32424669 93719442SHREVEPORT PHYSICAL THERAPY & SPORTS MEDICINE Kenney, III Robert A. PT 1453 East Bert Kouns Shreveport LA 71105 35 65 1 none 1 2 2 32424669 93719442SHREVEPORT PHYSICAL THERAPY & SPORTS MEDICINE Powell Stanley E. PT 1453 East Bert Kouns Shreveport LA 71105 35 65 1 none 1 2 2 32424669 93719442SHREVEPORT PHYSICAL THERAPY & SPORTS MEDICINE Tubre Richard A. PT, OCS 1453 East Bert Kouns Shreveport LA 71105 35 65 1 none 1 2 2 32424669 93719442SHREVEPORT PHYSICAL THERAPY & SPORTS MEDICINE Wheelan Timothy M. 1453 East Bert Kouns Shreveport LA 71105 35 65 1 none 1 2 2 32424669 93719442CHRISTUS HEALTH NORTHERN LA 1453 East Bert Kouns Industrial Loop Shreveport LA 71105 60 86 1 none 1 2 1 32424669 93719442


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HIGHLAND CLINIC Green, Jr. M. Ragan MD 1455 E. Bert Kouns Suite 210 Shreveport LA 71105 20 20 1 none 1 2 2 32424701 93719427ORTHO RX INC 1455 E. Bert Kounss, Ste. 200 Shreveport LA 71105 40 54 1 none 1 2 2 32424701 93719427SUREACCESS MD, LLC 1455 East Bert Kouns Ste 105 Shreveport LA 71105 20 41 1 >=18 1 2 2 32424701 93719427HIGHLAND CLINIC Auer Powell B. MD 1455 East Bert Kouns Suite 210 Shreveport LA 71105 20 20 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Barnes Jon C. FNP 1455 East Bert Kouns Suite 210 Shreveport LA 71105 78 79 1 none 1 2 1 32424701 93719427HIGHLAND CLINIC Chico Michelle A. MD 1455 East Bert Kouns 3rd Floor Shreveport LA 71105 20 2E 1 >=18 1 2 2 32424701 93719427HIGHLAND CLINIC Cooksey David MD 1455 East Bert Kouns Suite 308 Shreveport LA 71105 20 07 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Glenniken Roan L. MD 1455 East Bert Kouns 3rd Floor Shreveport LA 71105 20 41 1 >=16 1 2 2 32424701 93719427HIGHLAND CLINIC Goodman Carl G. MD 1455 East Bert Kouns Suite 210 Shreveport LA 71105 20 20 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Harris Maghan K. MD 1455 East Bert Kouns Suite 109 Shreveport LA 71105 20 13 1 >=16 1 2 2 32424701 93719427HIGHLAND CLINIC Henderson Leigh MD 1455 East Bert Kouns Suite 109 Shreveport LA 71105 35 65 1 >=16 1 2 2 32424701 93719427HIGHLAND CLINIC Houtz Carlton G. MD 1455 East Bert Kouns Suite 210 Shreveport LA 71105 20 20 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Hunt William S. MD 1455 East Bert Kouns 3rd Floor Shreveport LA 71105 20 41 1 >=16 1 2 2 32424701 93719427HIGHLAND CLINIC Johnson Lori R. MD 1455 East Bert Kouns Suite 101 Shreveport LA 71105 20 03 1 none 1 2 1 32424701 93719427HIGHLAND CLINIC Kampert Kurt W. MD 1455 East Bert Kouns Suite 210 Shreveport LA 71105 20 2M 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Kamphuis Deanna C. NP 1455 East Bert Kouns 3rd Floor Shreveport LA 71105 78 79 1 >=16 1 2 2 32424701 93719427HIGHLAND CLINIC Knight Daniel R. 1455 East Bert Kouns Suite 106 Shreveport LA 71105 20 24 1 none 1 2 2 32424701 93719427SUREACCESS MD, LLC McCarty Emma E.K. MD 1455 East Bert Kouns Ste 105 Shreveport LA 71105 20 41 1 >=16 1 2 2 32424701 93719427HIGHLAND CLINIC Mead Gordon M. MD 1455 East Bert Kouns Shreveport LA 71105 20 20 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Parker, Jr. J. William MD 1455 East Bert Kouns Suite 205 Shreveport LA 71105 20 04 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Popwell Benny M. MD 1455 East Bert Kouns Suite 305 Shreveport LA 71105 20 16 1 >=16 1 2 1 32424701 93719427HIGHLAND CLINIC Rice, Jr. Clifford H. MD 1455 East Bert Kouns Shreveport LA 71105 20 04 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Robinson James R. MD 1455 East Bert Kouns Suite 206 Shreveport LA 71105 20 04 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Rushing Donna J. MD 1455 East Bert Kouns 3rd floor Shreveport LA 71105 20 2E 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Rushing Paul A. MD 1455 East Bert Kouns 3rd Floor Shreveport LA 71105 20 41 1 >=16 1 2 2 32424701 93719427HIGHLAND CLINIC Scaltsas Irene MD 1455 East Bert Kouns Suite 109 Shreveport LA 71105 20 13 1 >=16 1 2 2 32424701 93719427HIGHLAND CLINIC Springmeyer Craig R. MD 1455 East Bert Kouns Suite 210 Shreveport LA 71105 20 20 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Stokes Broke B. NP 1455 East Bert Kouns Suite 306 Shreveport LA 71105 78 16 1 >=16 1 2 2 32424701 93719427HIGHLAND CLINIC Washburne Willard F. MD 1455 East Bert Kouns Suite 108 Shreveport LA 71105 20 03 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC White Stephen C. MD 1455 East Bert Kouns Suite 202 Shreveport LA 71105 20 2P 1 >=16 1 2 2 32424701 93719427HIGHLAND CLINIC Whited Steven C. MD 1455 East Bert Kouns Suite 101 Shreveport LA 71105 20 03 1 none 1 2 2 32424701 93719427C. H. Wilkinson Physican Network Anissian Laura MD 1455 East Bert Kouns Loop 2nd Floor Shreveport LA 71105 20 41 1 >=18 1 2 2 32424701 93719427C. H. Wilkinson Physican Network Davis Johnathan MD 1455 East Bert Kouns Loop 2nd Floor Shreveport LA 71105 20 06 1 none 1 2 2 32424701 93719427C. H. Wilkinson Physican Network Palmer April MD 1455 East Bert Kouns Loop 2nd Floor Shreveport LA 71105 20 08 1 None 1 2 2 32424701 93719427C. H. Wilkinson Physican Network Rembert Paula MD 1455 East Bert Kouns Loop 2nd Floor Shreveport LA 71105 20 16 1 >=16 1 2 2 32424701 93719427C. H. Wilkinson Physican Network Persson David MD 1455 East Bert Kouns Loop 2nd Floor Shreveport LA 71105 20 41 1 >=18 1 2 2 32424701 93719427HIGHLAND CLINIC Anglin Edward L. MD 1455 East Bert Kouns, #210 Shreveport LA 71105 20 20 1 none 1 2 2 32424701 93719427HIGHLAND CLINIC Dockendorf Brian L. MD 1455 East Burt Kouns Suite 203 Shreveport LA 71105 20 02 1 none 1 2 2 32424701 93719427NORTHWEST IMAGING Holton Don B. MD 1460 E. Bert Kouns #708 Shreveport LA 71105 20 30 1 none 1 2 2 32424883 93719692180 MEDICAL INC 1950 East 70th Street Suite H Shreveport LA 71105 40 54 1 none 1 2 1 32443540 93710683WARDELL INTERESTS INC. Lovitt Ashley M. OT 2522 E. 70th St Shreveport LA 71105 37 74 1 none 1 2 2 32447489 93699447LABCORP 2920 KNIGHT ST STE 108 SHREVEPORT LA 71105 20 30 1 none 1 1 2 32483812 93707603MCFARLAND HEALTHCARE CLINIC McFarland Mairus T. 3331 Youree Drive Shreveport LA 71105 20 08 1 none 1 2 1 32479354 93722001FAMILY FOOT AND ANKLE CLINIC Okereke Edozie C. MD 3626 Youree Dr Shreveport LA 71105 32 48 1 none 1 2 1 32473094 93722298MARY E. MCWILLIAMS MD McWilliams Mary E. MD 4300 Youree Ste 250 Shreveport LA 71105 20 13 1 >=18 1 2 2 32462217 93722264AMERICAN HOME MEDICAL EQUIPMENT 6560 Youree Drive, Suite 1009 Shreveport LA 71105 40 54 1 none 1 2 2 32446211 93720498CHARLES D. SHANKS, O.D. Shanks Charles D. 7110 Youvee Drive Shreveport LA 71105 28 88 1 none 1 2 2 32448439 93704347ORTHO RX INC 7925 Youree Dr., Ste. 230 Shreveport LA 71105 40 54 1 none 1 2 2 32432779 93712102MEDICAL TECHNOLOGY OF LA INC 8860 Quimper Place Ste 200 Shreveport LA 71105 40 54 1 none 1 2 2 32420355 93726702RICHARDSON MEDICAL CENTER Mashburn Jay P. 10002 Canterbury Dr Shreveport LA 71106 20 1T 1 none 1 2 1 32378874 93721534


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KIKELOMO TOGUN Togun Kikelomo MBBS 214 West 70th St Shreveport LA 71106 20 37 1 <=18 1 2 1 32442160 93759174REGIONAL UROLOGY ASC LLC Callaway Mark W. MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Cline Kevin J. MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Germany Raymond MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Grigsby Tobin H. MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Henderson R. J. MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Henry Gerard D. MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Mook Tommy Moses MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Moss James L. MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Noble James R MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Palmer Thomas E MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Savage John Van MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 1 32398115 93757626REGIONAL UROLOGY ASC LLC Smith Stanley J MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Spinazze Ernesto A MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626REGIONAL UROLOGY ASC LLC Stage Chris MD 255 Bert Kouns Shreveport LA 71106 20 34 1 none 1 2 2 32398115 93757626MOBILE FOOT SPECIALIST INC Hudson Cassell DPM 2855 Long Lake Dr Shreveport LA 71106 32 48 1 >=18 1 2 2 32357480 93702475HIGHLAND CLINIC Walker Donna A. MD 301 Bert Kouns Shreveport LA 71106 20 2H 1 none 1 2 1 32398098 93759439THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson Bradley 385 Bert Kouns Suite 500 Shreveport LA 71106 35 65 1 none 1 2 2 32398064 93762962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Johnson Chere 385 Bert Kouns Suite 500 Shreveport LA 71106 35 65 1 none 1 2 2 32398064 93762962RADIOLOGY IMAGING ASSOC-LLP Grozinger Kurt T. MD 463 Ashley Ridge Blvd Shreveport LA 71106 20 30 1 none 1 2 1 32415356 93732016HIGHLAND CLINIC Cooper Stephan K. MD 471 Ashley Ridge Blvd Shreveport LA 71106 20 18 1 none 1 2 2 32415230 93731700HIGHLAND CLINIC Henderson Bruce C. MD 471 Ashley Ridge Blvd Shreveport LA 71106 20 18 1 none 1 2 2 32415230 93731700HIGHLAND CLINIC Berg M. Ellen MD 471 Ashley Ridge Blvd. Shreveport LA 71106 20 18 1 none 1 2 2 32415230 93731700HIGHLAND CLINIC Garrett Geoffrey W. MD 471 Ashley Ridge Blvd. Shreveport LA 71106 20 18 1 none 1 2 2 32415230 93731700Eye Care Inc. Bradford Ashley OD 5848 Line Ave Shreveport LA 71106 28 88 1 none 1 2 2 32455807 93746210Eye Care Inc. Brogden Alisa Pickering OD 5848 Line Ave Shreveport LA 71106 28 88 1 none 1 2 1 32455807 93746210Eye Care Inc. Pickering Michael D. OD 5848 Line Ave Shreveport LA 71106 28 88 1 none 1 2 1 32455807 93746210RANKIN FAMILY MEDICINE, LLC 725 N. Ashley Ridge Loop Ste 400 Shreveport LA 71106 20 16 1 >=16 1 2 2 32416571 93731750RANKIN FAMILY MEDICINE, LLC Herkey Tammi K. APRN 725 N. Ashley Ridge Loop Ste 400 Shreveport LA 71106 78 16 1 >=16 1 2 2 32416571 93731750RANKIN FAMILY MEDICINE, LLC Rankin Christopher J. MD 725 N. Ashley Ridge Loop Ste 400 Shreveport LA 71106 20 08 1 None 1 2 2 32416571 93731750WILSON B BABER MD LLC Baber Wilson B. MD 734 North Ashley Ridge Loop Shreveport LA 71106 20 18 1 none 1 2 2 32416725 93731227RADIOLOGY SPECIALISTS 855 Pierremont Road Suite 105 Shreveport LA 71106 20 30 1 none 1 2 2 32454567 93747021COULEUR COSMETICS BOUTIQUE & ACC. Roark Kitty A. 855 Pierremont, Suite 126 Shreveport LA 71106 40 54 1 none 1 2 2 32454567 93747021ACCUCARE MEDICAL LLC 9011 Linwood Avenue Shreveport LA 71106 40 54 1 none 1 2 2 32419299 93762886THE SCOOTER STORE-SHREVEPORT 9644 St. Vincent Ave. Shreveport LA 71106 40 54 1 none 1 2 2 32380213 93720714ASHLEY MEDICAL 1435 Haun Ave Shreveport LA 71107 40 54 1 >=18 1 2 2 32536706 93764495LINCARE INC 1520 N HEARNE AVENUE #120 SHREVEPORT LA 71107 40 54 1 none 1 1 2 32538086 93769081DAVID RAINES COMM HEALTH CENTER 1625 David Raines Road Shreveport LA 71107 72 9L 1 none 1 2 2 32535880 93828754DAVID RAINES COMM HEALTH CENTER Drake Alexandra NP 1625 David Raines Road Shreveport LA 71107 78 08 1 >=18 1 2 2 32535880 93828754DAVID RAINES COMM HEALTH CENTER Farmer Betty FNP 1625 David Raines Road Shreveport LA 71107 78 08 1 None 1 2 1 32535880 93828754DAVID RAINES COMM HEALTH CENTER Grados Flor D. MD 1625 David Raines Road Shreveport LA 71107 20 37 1 <=18 1 2 2 32535880 93828754DAVID RAINES COMM HEALTH CENTER Henderson George MD 1625 David Raines Road Shreveport LA 71107 20 08 1 None 1 2 1 32535880 93828754KING BARBARA ST King Barbara MS, CCC-SLP4646 Hilry Huckaby III Ave. Shreveport LA 71107 29 71 1 none 1 2 2 32521400 93813100JORDAN DAVID L OD Jordan David Lee 2601 Jewella Shreveport LA 71109 28 88 1 none 1 2 1 32487443 93797065THE DELTA PATHOLOGY GROUP LLC 2915 Missouri Ave Shreveport LA 71109 20 22 1 none 1 2 1 32484299 93782238ROUSSEAU JEAN W MD Rousseau Jean W. MD 4140 Hollywood Ave Shreveport LA 71109 20 02 1 none 1 2 1 32456698 93806678SHREVEPORT OXYGEN AND RENTAL McFarlain Susan 5150 Interstate Dr Ste 216 Shreveport LA 71109 40 54 1 none 1 2 2 32459288 93828873Apria Healthcare, Inc. 5201 Interstate Ave Ste 1 Shreveport LA 71109 40 54 1 none 1 1 2 32458837 93823494PHYSICIANS CHOICE HOME MEDICAL 1509 Doctors Dr. Bossier City LA 71111 40 54 1 none 1 2 1 32532704 93709891NORTH LA SURGERY CENTER Sasaki Larry S. MD 1512 Doctors Drive Bossier City LA 71111 20 02 1 none 1 2 2 32532806 93709567


LOI Contract STP*

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New Patient

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onPCP Link

Middle Initial

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HIGHLAND CLINIC Walker Donna A. MD 1512 Doctors Drive Bossier City LA 71111 20 2H 1 none 1 2 1 32532806 93709567DAVID RAINES COMM HEALTH CENTER 1514 Doctors Drive Bossier City LA 71111 72 9L 1 none 1 2 2 32532873 93709568DAVID RAINES COMM HEALTH CENTER Daniels Larry MD 1514 Doctors Drive Bossier City LA 71111 20 08 1 None 1 2 1 32532873 93709568DAVID RAINES COMM HEALTH CENTER Drake Alexandra NP 1514 Doctors Drive Bossier City LA 71111 78 08 1 >=18 1 2 2 32532873 93709568DAVID RAINES COMM HEALTH CENTER Grados Flor D. MD 1514 Doctors Drive Bossier City LA 71111 20 37 1 <=18 1 2 2 32532873 93709568DAVID RAINES COMM HEALTH CENTER Koduru Suneetha MD 1514 Doctors Drive Bossier City LA 71111 20 08 1 None 1 2 2 32532873 93709568DAVID RAINES COMM HEALTH CENTER Parker Charlene Mary FNP 1514 Doctors Drive Bossier City LA 71111 78 08 1 None 1 2 2 32532873 93709568DAVID RAINES COMM HEALTH CENTER Pratibha Anne MD 1514 Doctors Drive Bossier City LA 71111 20 08 1 None 1 2 2 32532873 93709568BALENTINE AMBUL SERVICE INC 1625 Benton Rd Bossier City LA 71111 51 59 1 none 1 2 2 32534244 93720562CUSTOM HEALTHCARE INC Callahan Mike E. 1701 Old Minden Rd. Suite 17G Bossier City LA 71111 40 54 1 none 1 2 2 32516269 93716267ADAMS S CHARLES OD Adams Charles S. OD 1911 Benton Rd. Ste C Bossier City LA 71111 28 88 1 none 1 2 2 32537130 93721229SOUTHERN REHAB & HOME MEDICAL CTR 2207 California Dr. Suite 9A Bossier City LA 71111 40 54 1 none 1 2 1 32537039 93722259BAUMAN DALE V MD Bauman Dale V. MD 2300 Hospital Dr Ste 310 Bossier City LA 71111 20 16 1 >=16 1 2 1 32557786 93723457BOSSIER EYE INSTITUTE Nawas Wally 2300 Hospital Drive, Ste. 140 Bossier City LA 71111 20 18 1 none 1 2 2 32557786 93723457THE INTENSIVIST GROUP LLC Lambert Ronald S. MD 2525 Viking Dr Bossier City LA 71111 20 29 1 none 1 2 2 32555437 93721635SAMARITAN HOME MEDICAL EQUIPMENT 2801 Northside Dr., Ste. 11 Bossier City LA 71111 40 54 1 none 1 2 2 32538665 93709860THE PHYSICIAN'S ALLIANCE CORP (TPAC) Zytkoskee Tracy 2906 Plantation Bossier City LA 71111 35 65 1 none 1 2 2 32540201 93708725PAYLESS OPTICAL OUTLET 3153 East Texas St Bossier City LA 71111 28 88 1 none 1 2 1 32528996 93699152NORTHWEST MEDICAL SUPPLY LLC 4101 Viking Dr. Suite X Bossier City LA 71111 40 54 1 none 1 2 2 32550944 93685759ROUGEAU ROBERT A Rougeau Robert A. DC 925 Benton Rd. Bossier City LA 71111 30 35 1 none 1 2 2 32529124 93719019BOSSIER FAMILY EYE CARE Pastilong Christine K. OD 927 Benton Rd Bossier City LA 71111 28 88 1 none 1 2 1 32529143 93719026HIGHLAND CLINIC Walker Donna A. MD 2323 Old Minden Road Bossier City LA 71112 20 2H 1 none 1 2 1 32519491 93703745VINELCO PHYSICIANS ASSOCIATES Chico Gavin F. MD 4900 Medical Dr Bossier City LA 71112 20 41 1 >=16 1 2 1 32460885 93667874VINELCO PHYSICIANS ASSOCIATES Chico Michelle A. MD 4900 Medical Dr Bossier City LA 71112 20 41 1 >=16 1 2 2 32460885 93667874GLADNEY MARLER & ASSOCIATES Marler Kevin C. 8001 Youree Drive Ste 840 Shreveport LA 71115 20 02 1 none 1 2 2 32431727 93711495SNELLS LIMB & BRACE COMPANY 8730 Youree Ste A Shreveport LA 71115 40 53 1 none 1 2 2 32421893 93706453ASSOCIATED MEDICAL & OXYGEN SUPPLY INC 8870 Youree Drive, Ste. 107 Shreveport LA 71115 40 54 1 none 1 2 1 32418253 93704339CHARLES D. SHANKS, O.D. Shanks Charles D. 9116 Copperman Court Shreveport LA 71115 28 88 1 none 1 2 2 32407630 93701303MONTGOMERY CYNTHIA G MD Montgomery Cynthia G. MD 2508 Bert Kouns Ste 401 Shreveport LA 71118 20 16 1 none 1 2 1 32402182 93798376CATHERINE F. VANDERLOOS, MD, AMC, INC Vanderloos Catherine F. MD 2508 Bert Kouns Ind Loop Suite 400 Shreveport LA 71118 20 16 1 >=16 1 2 1 32402182 93798376SYNERGY HOME CARE-NORTHWESTERN REGION, INC 2533 Bert Kouns Industrial Loop Shreveport LA 71118 44 75 1 none 1 2 2 32401911 93798726SHREVEPORT DIABETIC SHOES Dodson James 8837 Kingston Rd Shreveport LA 71118 40 54 1 none 1 2 2 32411624 93780185JOHNSTON F PAUL DC Johnston Paul F. DC 9141 Walker Rd Shreveport LA 71118 30 35 1 none 1 2 2 32405194 93814470REGIONAL MEDICAL RENTAL & SALES 9422 Kingston Rd. Shreveport LA 71118 40 54 1 none 1 2 2 32393278 93780651ABUBAKAR IBRAHIM Ibrahim Abubakar MD 6821 Pines Rd Ste 300 Shreveport LA 71129 20 08 1 none 1 2 1 32445418 93862282TONYA CLAYTON Clayton Tonya MD 6821 Pines Rd. #200 Shreveport LA 71129 20 41 1 none 1 2 1 32445418 93862282SHREVEPORT FAMILY MED/KID MED Arterberry Katherine FNP 7505 Pines Rd Ste 1250 Shreveport LA 71129 78 08 1 none 1 2 2 32434652 93861803SHREVEPORT FAMILY MED/KID MED Ibrahim Abubakar MD 7505 Pines Rd Ste 1250 Shreveport LA 71129 20 08 1 none 1 2 1 32434652 93861803SHREVEPORT FAMILY MED/KID MED McFarland Mairus MD 7505 Pines Rd Ste 1250 Shreveport LA 71129 20 08 1 none 1 2 1 32434652 93861803SHREVEPORT FAMILY MED/KID MED Mirza Ishrat MD 7505 Pines Rd Ste 1250 Shreveport LA 71129 20 08 1 none 1 2 2 32434652 93861803SHREVEPORT FAMILY MED/KID MED 7505 Pines Rd. Ste 1250 Shreveport LA 71129 78 08 1 none 1 2 1 32434652 93861803LACAM MEDICAL SUPPLIES LLC Ely James D. 7505 Pines Road Ste 1200-I Shreveport LA 71129 40 54 1 none 1 2 2 32434652 93861803HAYNES MICHAEL J OD Haynes Michael J. 1020 N. 3rd Street Monroe LA 71201 28 88 1 none 1 2 1 32510426 92121850REGIONAL MEDICAL RENTAL & SALES 1119 Forsythe Avenue Monroe LA 71201 40 54 1 none 1 2 2 32525469 92123046AFFINITY HEALTH GROUP LLC Melton Stuart Lee 112 Saint John St. Monroe LA 71201 20 08 1 none 1 2 2 32501657 92117191AFFINITY HEALTH GROUP LLC Proctor Gwen H. 112 Saint John St. Monroe LA 71201 20 08 1 none 1 2 2 32501657 92117191AFFINITY HEALTH GROUP LLC Raulerson Robert M. 112 Saint John St. Monroe LA 71201 20 08 1 none 1 2 2 32501657 92117191AFFINITY HEALTH GROUP LLC Ross Theresa Jones 112 Saint John St. Monroe LA 71201 20 08 1 none 1 2 2 32501657 92117191KATINA BEVERLY 1203 NORTH 5TH STREET MONROE LA 71201 32 48 1 none 1 1 2 32513854 92122208PREMIER HOPE ORTHOTIC & PROST Graham A. Blain 1209 Royal Avenue Monroe LA 71201 40 53 1 none 1 2 2 32517335 92114898


LOI Contract STP*

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New Patient

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PREMIER HOPE ORTHOTIC & PROST Lindsley Steven H. 1209 Royal Avenue Monroe LA 71201 40 53 1 none 1 2 2 32517335 92114898COOKSEY JOHN MD Cooksey John MD 1310 N. 19th St Monroe LA 71201 20 18 1 none 1 2 2 32522562 92108648HEALTH SERVICES OF NORTH LOUISIANA Elias Francis D. MD 1601 Lamy Lane Monroe LA 71201 20 30 1 none 1 2 1 32530977 92093863HEALTH SERVICES OF NORTH LOUISIANA McDonald Brenton W. MD 1601 Lamy Lane Monroe LA 71201 20 30 1 none 1 2 1 32530977 92093863SYNERGY HOME CARE-NORTHEASTERN REGION, INC 1605 Stubbs Ave Monroe LA 71201 44 75 1 none 1 2 2 32518860 92110805HIGHLAND CLINIC Richards Alan B. MD 1804 N. 7th Monroe LA 71201 20 18 1 none 1 2 1 32520525 92124676DILLINGHAM OPTICAL INC 1812 Roselawn Ave Monroe LA 71201 75 88 1 none 1 2 2 32521320 92109955THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boardman Brent 1910 Stubbs Avenue Monroe LA 71201 35 65 1 none 1 2 2 32520694 92107395THE PHYSICIAN'S ALLIANCE CORP (TPAC) Enlow Brian 1910 Stubbs Avenue Monroe LA 71201 35 65 1 none 1 2 2 32520694 92107395THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guilbeau Glenn 1910 Stubbs Avenue Monroe LA 71201 35 65 1 none 1 2 2 32520694 92107395THE PHYSICIAN'S ALLIANCE CORP (TPAC) Richardson Jon 1910 Stubbs Avenue Monroe LA 71201 35 65 1 none 1 2 2 32520694 92107395OUACHITA MEDICAL IMAGING LLC Hollenberg, III Henry G. MD 200 A Louisville Ave Monroe LA 71201 20 30 1 none 1 2 1 32511583 92127263OUACHITA MEDICAL IMAGING LLC Hopkins Braud John A. MD 200 A Louisville Ave Monroe LA 71201 20 30 1 none 1 2 1 32511583 92127263OUACHITA MEDICAL IMAGING LLC Pate Steven W. MD 200 A Louisville Ave Monroe LA 71201 20 30 1 none 1 2 1 32511583 92127263LUFFEYS MED & SURG SUPPLY 2000 B. Tower Dr. Monroe LA 71201 40 54 1 none 1 2 2 32552164 92108499OUACHITA MEDICAL IMAGING LLC Atchison David James MD 2008 A Louisville Ave Monroe LA 71201 20 30 1 none 1 2 1 32542636 92120107OUACHITA MEDICAL IMAGING LLC Broyles Michael O. MD 2008 A Louisville Ave Monroe LA 71201 20 30 1 none 1 2 1 32542636 92120107OUACHITA MEDICAL IMAGING LLC Green Warren J. MD 2008 A Louisville Ave Monroe LA 71201 20 30 1 none 1 2 2 32542636 92120107OUACHITA MEDICAL IMAGING LLC 2008A Louisville Ave Monroe LA 71201 20 30 1 none 1 2 2 32518922 92104228LOUISIANA PAIN CARE LLC 210 Layton Ave. Monroe LA 71201 20 05 1 none 1 2 2 32497545 92112126SNELLS LIMB & BRACE COMPANY 211 Hall St Monroe LA 71201 40 53 1 none 1 2 2 32502875 92113350SURLES OPTICAL Surles Walter Elvis 2209 Forsythe Ave Monroe LA 71201 28 88 1 none 1 2 2 32535177 92107730RICHARDSON MEDICAL CENTER Lux Jeffrey 2220 Justice Monroe LA 71201 32 48 1 none 1 2 2 32536157 92108203MEDICAL TECHNOLOGY OF LA INC 2401 Ferrand Monroe LA 71201 40 54 1 none 1 2 2 32530040 92082389HEALTH SERVICES OF NORTH LOUISIANA Oyefara Benjamin I. MD 2908 Evangeline St. Monroe LA 71201 20 03 1 none 1 2 1 32533501 92091463PRIMARY HEALTH SERVICES CENTER 2913 Desiard St Monroe LA 71201 72 9L 1 none 1 2 1 32518879 92088933PRIMARY HEALTH SERVICES CENTER Carter Sandra FNPC 2913 Desiard St Monroe LA 71201 78 08 1 None 1 2 1 32518879 92088933PRIMARY HEALTH SERVICES CENTER Clark Rebecca FNP-C 2913 Desiard St Monroe LA 71201 78 08 1 None 1 2 1 32518879 92088933PRIMARY HEALTH SERVICES CENTER Ganj Farnaz Almas OB/GYN 2913 Desiard St Monroe LA 71201 20 16 1 >=16 1 2 1 32518879 92088933PRIMARY HEALTH SERVICES CENTER Morrow Melody FNP-C 2913 Desiard St Monroe LA 71201 78 08 1 None 1 2 2 32518879 92088933PRIMARY HEALTH SERVICES CENTER Poliquit Raymond MD 2913 Desiard St Monroe LA 71201 20 37 1 <=18 1 2 1 32518879 92088933PRIMARY HEALTH SERVICES CENTER Pope Sheila FNP-C 2913 Desiard St Monroe LA 71201 78 08 1 None 1 2 1 32518879 92088933PRIMARY HEALTH SERVICES CENTER Suddala Satheesh MD 2913 Desiard St Monroe LA 71201 20 08 1 None 1 2 2 32518879 92088933PRIMARY HEALTH SERVICES CENTER Washington Adrain FNP-C 2913 Desiard St Monroe LA 71201 78 08 1 None 1 2 1 32518879 92088933PRIMARY HEALTH SERVICES CENTER 2914 Betin Ave Monroe LA 71201 72 9L 1 none 1 2 1 32520125 92087920PRIMARY HEALTH SERVICES CENTER Carter Sandra FNPC 2914 Betin Ave Monroe LA 71201 78 08 1 None 1 2 1 32520125 92087920PRIMARY HEALTH SERVICES CENTER Clark Rebecca FNP-C 2914 Betin Ave Monroe LA 71201 78 08 1 None 1 2 1 32520125 92087920PRIMARY HEALTH SERVICES CENTER Ganj Farnaz Almas OB/GYN 2914 Betin Ave Monroe LA 71201 20 16 1 >=16 1 2 1 32520125 92087920PRIMARY HEALTH SERVICES CENTER Morrow Melody FNP-C 2914 Betin Ave Monroe LA 71201 78 08 1 None 1 2 2 32520125 92087920PRIMARY HEALTH SERVICES CENTER Poliquit Raymond MD 2914 Betin Ave Monroe LA 71201 20 37 1 <=18 1 2 1 32520125 92087920PRIMARY HEALTH SERVICES CENTER Pope Sheila FNP-C 2914 Betin Ave Monroe LA 71201 78 08 1 None 1 2 1 32520125 92087920PRIMARY HEALTH SERVICES CENTER Suddala Satheesh MD 2914 Betin Ave Monroe LA 71201 20 08 1 None 1 2 2 32520125 92087920PRIMARY HEALTH SERVICES CENTER Washington Adrain FNP-C 2914 Betin Ave Monroe LA 71201 78 08 1 None 1 2 1 32520125 92087920GORDON WILLIAM D OD Gordon William D. 3000 Forsythe Ave. Monroe LA 71201 28 88 1 none 1 2 1 32540677 92098519OLADAPO LAPITE Lapite Oladapo MD, FAAFP 306 Stone Ave Monroe LA 71201 20 08 1 None 1 2 1 32497375 92110360LINCARE INC 308 Arkansas Ave Monroe LA 71201 40 54 1 none 1 2 1 32508011 92119698LINCARE INC 308 ARKANSAS AVENUE MONROE LA 71201 40 54 1 none 1 1 2 32508011 92119698MEDICAL ASSOC OF NORTHEAST LA Mouhaffel Assad H. 309 Jackson St St. Francis Medical Monroe LA 71201 20 06 1 >=18 1 2 1 32500032 92114764PARISH ANESTHESIA OF MONROE Beebe Johnathan L. MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Boyd Chris CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

PARISH ANESTHESIA OF MONROE Brown Sperry CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Butler, II Larrie Huson CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 1 32500032 92114764PARISH ANESTHESIA OF MONROE Cullipher-Pinton Lora A CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 1 32500032 92114764PARISH ANESTHESIA OF MONROE Davenport, Jr. Charles W. MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Dunn, II Michael Bernard MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Embanato Stacy Brown CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Ferguson Christopher CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Freeman James Carlton MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Freeman Sonya Gatlin CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 1 32500032 92114764PARISH ANESTHESIA OF MONROE Gates Carolyn S. CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Gavin Roy Curtis CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Gibson Richard Wade CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Hart Sarah Fields CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 1 32500032 92114764PARISH ANESTHESIA OF MONROE Hendrick, Jr. Robert Smith MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Herndon Anna CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Little Robert Edwin CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE McKnight Denise A. MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Plunkett Robert CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Richey John V. MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Rupert Gary Madden MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Ruthledge-Hilburn Brenda CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Sehon Charles K. MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Spence Lori Yount CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Thibodeaux Wayne Joseph MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Thomas Randal CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Valentine Ginger Lester CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Willis Teresa H. CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 1 32500032 92114764PARISH ANESTHESIA OF MONROE Young Ellen CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 1 32500032 92114764PARISH ANESTHESIA OF MONROE Young James Dalton CRNA 309 Jackson Street Monroe LA 71201 91 05 1 none 1 2 1 32500032 92114764PARISH ANESTHESIA OF MONROE Yumet Luis A. MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764PARISH ANESTHESIA OF MONROE Zeh Cynthia Marie MD 309 Jackson Street Monroe LA 71201 20 05 1 none 1 2 2 32500032 92114764THE DELTA PATHOLOGY GROUP LLC 309 Lauks St Monroe LA 71201 20 22 1 none 1 2 1 32533967 92108898MONROE CARDIOVASCULAR ASSOCIATES Chaudry Imaran T. 3100 Forsythe Ave Monroe LA 71201 20 06 1 none 1 2 1 32541229 92097661AFFINITY HEALTH GROUP LLC Grino Marie M. 3116 Kilpatrick Blvd. Monroe LA 71201 20 37 1 none 1 2 2 32526075 92090569AFFINITY HEALTH GROUP LLC Khanfar Nashat M. 3116 Kilpatrick Blvd. Monroe LA 71201 20 37 1 none 1 2 1 32526075 92090569AFFINITY HEALTH GROUP LLC Yusuf Munira A. 3116 Kilpatrick Blvd. Monroe LA 71201 20 37 1 none 1 2 1 32526075 92090569MEDICAL ASSOC OF NORTHEAST LA 312 Grammont St P&S Surgical Hosp Monroe LA 71201 20 06 1 none 1 2 2 32501032 92115128RICHARDSON MEDICAL CENTER Brown Douglas C. 312 Grammont St Ste 302 Monroe LA 71201 20 20 1 none 1 2 2 32501032 92115128MEDICAL ASSOC OF NORTHEAST LA Mouhaffel Assad H. 312 Grammont St P&S Surgical Hosp Monroe LA 71201 20 06 1 >=18 1 2 1 32501032 92115128SMSO ANESTHESIA LLC Allen Clara D. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Bell Frankie T. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 1 32501032 92115128SMSO ANESTHESIA LLC Borders Robert W. 312 Grammont St #101 Monroe LA 71201 20 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Boyd Chris E. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Brown Sperry A. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Clark Hannah C. 312 Grammont St #101 Monroe LA 71201 20 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Donias Cherie C. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Duty Heather D. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Embanato Joseph T. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Ferguson Christopher L. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Gates Paula M. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

SMSO ANESTHESIA LLC Gilbert Kory M. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Hancock Jennifer B. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 1 32501032 92115128SMSO ANESTHESIA LLC Harrison Ralph B. 312 Grammont St #101 Monroe LA 71201 20 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Hendrick Robert S. 312 Grammont St #101 Monroe LA 71201 20 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Leath Mark S. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Little Robert E. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Martin Marti M. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Mitchell Lori C. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Parkman Jill A. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Ruthledge-Hilburn Brenda 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Smiley Erin Shane 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Snellings Satchie B. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Spence Lori Y. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Wheeler Anice H. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Willis Teresa H. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 1 32501032 92115128SMSO ANESTHESIA LLC Wisenor Randall E. 312 Grammont St #101 Monroe LA 71201 91 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Stage Rosemary B. MD 312 Grammont St, #101 Monroe LA 71201 20 05 1 none 1 2 2 32501032 92115128SMSO ANESTHESIA LLC Johnson Brian B. 312 Grammont St. #101 Monroe LA 71201 20 05 1 none 1 2 2 32501032 92115128WOMANS CLINIC OF MONROE Belsom William B. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 2 32501032 92115128WOMANS CLINIC OF MONROE Bryan David G. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 2 32501032 92115128WOMANS CLINIC OF MONROE Clark Dellie H. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 2 32501032 92115128WOMANS CLINIC OF MONROE Hall Peyton R. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 2 32501032 92115128WOMANS CLINIC OF MONROE Jackson Gwenn V. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 1 32501032 92115128WOMANS CLINIC OF MONROE Jopling Annie G. 312 Grammont St. Ste. 300 Monroe LA 71201 78 16 1 >=16 1 2 1 32501032 92115128WOMANS CLINIC OF MONROE Klug Sara 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 2 32501032 92115128WOMANS CLINIC OF MONROE LeBleu Vaszily Laurie R. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 1 32501032 92115128WOMANS CLINIC OF MONROE Lee Won S. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 1 32501032 92115128WOMANS CLINIC OF MONROE Pennebaker Dawn W. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 1 32501032 92115128WOMANS CLINIC OF MONROE Peveto Sherry S. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 1 32501032 92115128WOMANS CLINIC OF MONROE Salas Amber M. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 1 32501032 92115128WOMANS CLINIC OF MONROE Sheppard Tonya H. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 2 32501032 92115128WOMANS CLINIC OF MONROE Tugwell Terence R. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 2 32501032 92115128WOMANS CLINIC OF MONROE Walters Christie J. 312 Grammont St. Ste. 300 Monroe LA 71201 78 16 1 >=16 1 2 2 32501032 92115128WOMANS CLINIC OF MONROE Williams Adrienne M. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 2 32501032 92115128WOMANS CLINIC OF MONROE Wilson Jason B. 312 Grammont St. Ste. 300 Monroe LA 71201 20 16 1 >=16 1 2 1 32501032 92115128HEALTH SERVICES OF NORTH LOUISIANA Brown Douglas C. MD 312 Grammont Street Suite 302 Monroe LA 71201 20 20 1 none 1 2 2 32501032 92115128HEALTH SERVICES OF NORTH LOUISIANA Sutton Fletcher S. MD 312 Gramont St Monroe LA 71201 20 20 1 none 1 2 2 32501032 92115128WOMENS HEALTH SOURCE, LLC Caire Michael J. MD 410 Wood Street Monroe LA 71201 20 16 1 >=16 1 2 1 32500622 92113354WOMENS HEALTH SOURCE, LLC Smith Tina M. 410 Wood Street Monroe LA 71201 78 16 1 >=16 1 2 2 32500622 92113354HEALTH SERVICES OF NORTH LOUISIANA Greer Carlton R. MD 414 Wood St Monroe LA 71201 20 14 1 none 1 2 2 32500635 92113323FOUST DANA ST Foust Dana 44 Northgate Dr. Monroe LA 71201 29 71 1 none 1 2 2 32545986 92079902RANDY W HEAD MD APMC Head Randy W. MD 600 Grammont St Monroe LA 71201 20 08 1 none 1 2 1 32502182 92112352HEALTH SERVICES OF NORTH LOUISIANA Hinkle Henry H. MD 611 Grammont St Monroe LA 71201 20 10 1 none 1 2 2 32502454 92112466HEALTH SERVICES OF NORTH LOUISIANA Richert Arthur E. MD 611 Grammont St Monroe LA 71201 20 10 1 none 1 2 2 32502454 92112466HEALTH SERVICES OF NORTH LOUISIANA Boyce Gregory Arthur MD 611 Grammont Street Monroe LA 71201 20 10 1 none 1 2 2 32502454 92112466HEALTH SERVICES OF NORTH LOUISIANA Raines David R. MD 611 Grammont Street Monroe LA 71201 20 10 1 none 1 2 2 32502454 92112466HEALTH SERVICES OF NORTH LOUISIANA Seegers Robert L. MD 611 Grammont Street Monroe LA 71201 20 41 1 >=18 1 2 2 32502454 92112466INLAND CARDIOVASCULAR CLINIC Achilihu Onye Godfrey 614 N 2nd Street Monroe LA 71201 20 41 1 >=16 1 2 1 32506814 92120299MARGARET NELSON C ST Nelson Margaret 805 Auburn Ave Monroe LA 71201 29 71 1 none 1 2 2 32516648 92119795ASHLEY MEDICAL 806 N. 31st St. Ste D Monroe LA 71201 40 54 1 >=18 1 2 2 32530426 92089095


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

ST. FRANCIS CONVENIENCE CLINIC 920 Oliver Rd. Suite 1600 B Monroe LA 71201 20 08 1 None 1 2 1 32520303 92103165ST. FRANCIS CONVENIENCE CLINIC Blanson Deborah S. DNSC, FNP-BC920 Oliver Rd. Suite 1600 B Monroe LA 71201 78 08 1 none 1 2 2 32520303 92103165ST. FRANCIS CONVENIENCE CLINIC Crockett Alecia FNP-C 920 Oliver Rd. Suite 1600 B Monroe LA 71201 78 08 1 none 1 2 1 32520303 92103165ST. FRANCIS CONVENIENCE CLINIC Islam Nahid A. MD 920 Oliver Rd. Suite 1600 B Monroe LA 71201 20 08 1 none 1 2 2 32520303 92103165ST. FRANCIS CONVENIENCE CLINIC Mansfield Chelsea W. FNP-BC 920 Oliver Rd. Suite 1600 B Monroe LA 71201 78 08 1 none 1 2 2 32520303 92103165ST. FRANCIS CONVENIENCE CLINIC McNabb Mari W. FNP-C 920 Oliver Rd. Suite 1600 B Monroe LA 71201 78 08 1 none 1 2 2 32520303 92103165ST. FRANCIS CONVENIENCE CLINIC Shelby Rachel Pittman 920 Oliver Rd. Suite 1600 B Monroe LA 71201 78 08 1 none 1 2 2 32520303 92103165ST. FRANCIS CONVENIENCE CLINIC Smith Naomi R. FNP-C 920 Oliver Rd. Suite 1600 B Monroe LA 71201 78 08 1 none 1 2 2 32520303 92103165ST. FRANCIS CONVENIENCE CLINIC Stewart-Dixon Tammy FNP-BC 920 Oliver Rd. Suite 1600 B Monroe LA 71201 78 08 1 none 1 2 1 32520303 92103165ST. FRANCIS CONVENIENCE CLINIC Williams La Tonya W. FNP-BC 920 Oliver Rd. Suite 1600 B Monroe LA 71201 78 08 1 none 1 2 2 32520303 92103165RUSTON CLINIC COMPANY LLC Finley James S. MD 920 Oliver Rd., Ste. 1475 Monroe LA 71201 20 20 1 none 1 2 2 32520303 92103165RICHARDSON MEDICAL CENTER Islam Rezaul Monroe Cardiovascular Associates Monroe LA 71201 20 41 1 >=18 1 2 2 32501350 92100528GRACE MEDICAL EQUIP AND SUPPLY 1014 Winnsboro Rd. Monroe LA 71202 40 54 1 none 1 2 2 32483585 92093586JAMES PATTERSON Patterson James D. MD 1511 Orange St Monroe LA 71202 20 08 1 none 1 2 1 32499254 92093806KERMIT WALTERS JR Walters, Jr. Kermit L. MD 1910 Jackson St. Monroe LA 71202 20 08 1 none 1 2 1 32486144 92109801PRIMARY HEALTH SERVICES CENTER 850 South 2nd St Monroe LA 71202 72 9L 1 none 1 2 1 32490445 92106204PRIMARY HEALTH SERVICES CENTER Carter Sandra FNPC 850 South 2nd St Monroe LA 71202 78 08 1 None 1 2 1 32490445 92106204PRIMARY HEALTH SERVICES CENTER Clark Rebecca FNP-C 850 South 2nd St Monroe LA 71202 78 08 1 None 1 2 1 32490445 92106204PRIMARY HEALTH SERVICES CENTER Ganj Farnaz Almas OB/GYN 850 South 2nd St Monroe LA 71202 20 16 1 >=16 1 2 1 32490445 92106204PRIMARY HEALTH SERVICES CENTER Morrow Melody FNP-C 850 South 2nd St Monroe LA 71202 78 08 1 None 1 2 2 32490445 92106204PRIMARY HEALTH SERVICES CENTER Poliquit Raymond MD 850 South 2nd St Monroe LA 71202 20 37 1 <=18 1 2 1 32490445 92106204PRIMARY HEALTH SERVICES CENTER Pope Sheila FNP-C 850 South 2nd St Monroe LA 71202 78 08 1 None 1 2 1 32490445 92106204PRIMARY HEALTH SERVICES CENTER Suddala Satheesh MD 850 South 2nd St Monroe LA 71202 20 08 1 None 1 2 2 32490445 92106204PRIMARY HEALTH SERVICES CENTER Washington Adrain FNP-C 850 South 2nd St Monroe LA 71202 78 08 1 None 1 2 1 32490445 92106204HEALTH SERVICES OF NORTH LOUISIANA Smith James M. MD 2332 Sterlingtion Road Monroe LA 71203 20 08 1 None 1 2 2 32544149 92077355SHELL FAMILY CHIROPRACTIC CLINIC Bryant Steven Brent 3219 Hwy 165N Monroe LA 71203 30 35 1 none 1 2 1 32508443 92079546SHELL FAMILY CHIROPRACTIC CLINIC Shell James Michael 3219 Hwy 165N Monroe LA 71203 30 35 1 none 1 2 2 32508443 92079546AFFINITY HEALTH GROUP LLC Wootton James 3400 Medical Park Dr. Monroe LA 71203 20 08 1 none 1 2 2 32577938 92072113AFFINITY HEALTH GROUP LLC Yarbrough David A. 3400 Medical Park Dr. Monroe LA 71203 20 08 1 none 1 2 2 32577938 92072113AFFINITY HEALTH GROUP LLC Dyess Bonita Harvard 3401 Magnolia Cove Monroe LA 71203 20 37 1 none 1 2 1 32576602 92072307AFFINITY HEALTH GROUP LLC Zukowski Nancy Lynn 3401 Magnolia Cove Monroe LA 71203 20 37 1 none 1 2 2 32576602 92072307

MEDICAL ASSOC OF NORTHEAST LA Mouhaffel Assad H. 3421 Medical Park Dr Monroe LA 71203 20 06 1 >=18 1 2 1 32578159 92071696WOMANS CLINIC OF MONROE Belsom William B. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 2 32577881 92071698WOMANS CLINIC OF MONROE Bryan David G. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 2 32577881 92071698WOMANS CLINIC OF MONROE Clark Dellie H. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 2 32577881 92071698WOMANS CLINIC OF MONROE Hall Peyton R. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 2 32577881 92071698WOMANS CLINIC OF MONROE Jackson Gwenn V. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 1 32577881 92071698WOMANS CLINIC OF MONROE Jopling Annie G. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 78 16 1 >=16 1 2 1 32577881 92071698WOMANS CLINIC OF MONROE Klug Sara 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 2 32577881 92071698WOMANS CLINIC OF MONROE LeBleu Vaszily Laurie R. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 1 32577881 92071698WOMANS CLINIC OF MONROE Lee Won S. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 1 32577881 92071698WOMANS CLINIC OF MONROE Pennebaker Dawn W. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 1 32577881 92071698WOMANS CLINIC OF MONROE Peveto Sherry S. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 1 32577881 92071698WOMANS CLINIC OF MONROE Salas Amber M. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 1 32577881 92071698WOMANS CLINIC OF MONROE Sheppard Tonya H. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 2 32577881 92071698WOMANS CLINIC OF MONROE Tugwell Terence R. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 2 32577881 92071698WOMANS CLINIC OF MONROE Walters Christie J. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 78 16 1 >=16 1 2 2 32577881 92071698WOMANS CLINIC OF MONROE Williams Adrienne M. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 2 32577881 92071698WOMANS CLINIC OF MONROE Wilson Jason B. 3424 Medical Park Dr. Ste. 1 Monroe LA 71203 20 16 1 >=16 1 2 1 32577881 92071698

St. Francis North Hospital


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

AFFINITY HEALTH GROUP LLC Smith, Jr. Richard D. 3510 Medical Park Dr. Monroe LA 71203 20 41 1 none 1 2 2 32577674 92070196PHYSICIAN GROUP OF LOUISIANA Henry Joe Byron MD 3995 Sterlington Rd. Monroe LA 71203 20 08 1 None 1 2 2 32567906 92074332THOMAS WILLIAMS Williams Thomas S. MD 516 Lincoln Rd. Monroe LA 71203 20 08 1 None 1 2 2 32542868 92016612HEALTH SERVICES OF NORTH LOUISIANA Anjum Rubeena MD 8649 Hwy 165 North Monroe LA 71203 20 08 1 None 1 2 2 32684554 92046667HEALTH SERVICES OF NORTH LOUISIANA Fakhr Samina MD 8649 Hwy 165 North Monroe LA 71203 20 08 1 None 1 2 2 32684554 92046667PHYSICIAN GROUP OF LOUISIANA Anjum Rubeena MD 8649 Hwy 165 North #1 & 2 Monroe LA 71203 20 08 1 None 1 2 2 32684554 92046667PHYSICIAN GROUP OF LOUISIANA Fakhr Samina MD 8649 Hwy 165 North #1 & 2 Monroe LA 71203 20 08 1 None 1 2 2 32684554 92046667MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. 1001 W. Madison Bastrop LA 71220 72 9L 1 none 1 2 1 32775352 91924790MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. Gallien Susan FNP 1001 W. Madison Bastrop LA 71220 78 08 1 None 1 2 1 32775352 91924790MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. Wood Teresa A. FNP 1001 W. Madison Bastrop LA 71220 78 08 1 None 1 2 2 32775352 91924790United Home Care, Inc. 129 Elm Street Bastrop LA 71220 20 37 1 none 1 2 1 32779445 91904402HEALTH SERVICES OF NORTH LOUISIANA Cox Carter MD 206 South Vine Street Bastrop LA 71220 20 08 1 None 1 2 2 32777104 91915461RUSSELL RICHARD R OD Russell Richard R. OD 210 S. Odom St Bastrop LA 71220 28 88 1 none 1 2 1 32777977 91904638GUOTH JANOS G MD Guoth Janos MD 316 West Walnut Ave Bastrop LA 71220 20 16 1 none 1 2 1 32775457 91917081MOREHOUSE GENERAL HOSPITAL 323 W. Walnut St Bastrop LA 71220 60 86 1 none 1 2 2 32775184 91917143HEALTH SERVICES OF NORTH LOUISIANA Coats John M. MD 327 West Hickory Bastrop LA 71220 20 08 1 None 1 2 1 32776147 91917304HEALTH SERVICES OF NORTH LOUISIANA Noble Jack C. MD 355 West Hickory Ave. Bastrop LA 71220 20 08 1 None 1 2 2 32776144 91917626AFFINITY HEALTH GROUP LLC Noble Jack C. 355 West Hickory St. Bastrop LA 71220 20 08 1 none 1 2 2 32776144 91917626ANDY VAN TRAN Van Tran Andy MD 365 W. Hickory Ave. Bastrop LA 71220 20 08 1 none 1 2 2 32776137 91917728THE PHYSICIAN'S ALLIANCE CORP (TPAC) Barnes Leslye 3867 Bayou Acres Drive Bastrop LA 71220 37 74 1 none 1 2 2 32759181 91961771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Butler Nicholas 3867 Bayou Acres Drive Bastrop LA 71220 35 65 1 none 1 2 2 32759181 91961771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Freeland William 3867 Bayou Acres Drive Bastrop LA 71220 37 74 1 none 1 2 2 32759181 91961771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Laird Pamela 3867 Bayou Acres Drive Bastrop LA 71220 29 71 1 none 1 2 2 32759181 91961771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Martin Adam 3867 Bayou Acres Drive Bastrop LA 71220 37 74 1 none 1 2 2 32759181 91961771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Richardson Anita 3867 Bayou Acres Drive Bastrop LA 71220 37 74 1 none 1 2 2 32759181 91961771THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wood Dan 3867 Bayou Acres Drive Bastrop LA 71220 35 65 1 none 1 2 1 32759181 91961771GAREY E WARE OD Ware Garey E. OD 404 South Washington St Bastrop LA 71220 28 88 1 none 1 2 2 32775157 91914281HEALTH SERVICES OF NORTH LOUISIANA Robert John P. MD 420 S. Vine St. Bastrop LA 71220 20 02 1 none 1 2 2 32774985 91915469MOREHOUSE GENERAL HOSPITAL PHYSICIANS CLINIC 420 S. Vine Street Bastrop LA 71220 20 08 1 None 1 2 2 32774985 91915469MOREHOUSE GENERAL HOSPITAL PHYSICIANS CLINIC Adams Alyce MD 420 S. Vine Street Bastrop LA 71220 20 41 1 >=18 1 2 2 32774985 91915469MOREHOUSE GENERAL HOSPITAL PHYSICIANS CLINIC Brown-Manning Cynthia MD 420 S. Vine Street Bastrop LA 71220 20 08 1 none 1 2 2 32774985 91915469MOREHOUSE GENERAL HOSPITAL PHYSICIANS CLINIC Fields Thomas MD 420 S. Vine Street Bastrop LA 71220 20 04 1 none 1 2 1 32774985 91915469HEALTH SERVICES OF NORTH LOUISIANA Netherland Clint A. MD 427 South Vine St. Bastrop LA 71220 20 08 1 None 1 2 2 32774922 91915795HEALTH SERVICES OF NORTH LOUISIANA Khalil Mahmoud S. MD 501 Durham Bastrop LA 71220 20 06 1 none 1 2 1 32774184 91918093DANIEL TREJO, MD Trejo Daniel A. MD 511 Gunby Ave. Bastrop LA 71220 20 08 1 None 1 2 1 32774571 91918945MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. 518 Durham St Bastrop LA 71220 72 9L 1 none 1 2 1 32774048 91917764MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. Malik Shahzad MD 518 Durham St Bastrop LA 71220 20 37 1 <=18 1 2 1 32774048 91917764MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. Wade LaLisa FNP 518 Durham St Bastrop LA 71220 78 08 1 None 1 2 1 32774048 91917764MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. Wood Teresa A. FNP 518 Durham St Bastrop LA 71220 78 08 1 None 1 2 2 32774048 91917764HEALTH SERVICES OF NORTH LOUISIANA Trejo Daniel A. MD 518/520 Durham Street Bastrop LA 71220 20 08 1 None 1 2 1 32796481 91904376HEALTH SERVICES OF NORTH LOUISIANA Bhandari Bal R. MD 616 South Washington Bastrop LA 71220 20 10 1 none 1 2 1 32773319 91914244HEALTH SERVICES OF NORTH LOUISIANA Ziegler John S. MD 618 S. Washington Street Bastrop LA 71220 20 16 1 >=16 1 2 1 32773299 91914243MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. 625 S. Washington Bastrop LA 71220 72 9L 1 none 1 2 1 32773223 91914568MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. Wood Teresa A. FNP 625 S. Washington Bastrop LA 71220 78 08 1 None 1 2 2 32773223 91914568MOREHOUSE GENERAL HOSPITAL PHYSICIANS CLINIC 644 E. Jefferson Bastrop LA 71220 20 08 1 None 1 2 2 32777591 91906519MOREHOUSE GENERAL HOSPITAL PHYSICIANS CLINIC Adams Alyce MD 644 E. Jefferson Bastrop LA 71220 20 41 1 >=18 1 2 2 32777591 91906519MOREHOUSE GENERAL HOSPITAL PHYSICIANS CLINIC Brown-Manning Cynthia MD 644 E. Jefferson Bastrop LA 71220 20 08 1 none 1 2 2 32777591 91906519MOREHOUSE GENERAL HOSPITAL PHYSICIANS CLINIC Fields Thomas MD 644 E. Jefferson Bastrop LA 71220 20 04 1 none 1 2 1 32777591 91906519RICHARDSON MEDICAL CENTER Folse Craig P. 1240 Richardson Rd Calhoun LA 71225 20 30 1 none 1 2 1 32550183 92345790CALHOUN FAMILY CARE CLINIC 202 Highway 80 East Calhoun LA 71225 20 08 1 None 1 2 2 32520200 92326764


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

CALHOUN FAMILY CARE CLINIC Zuber Rita D. 202 Highway 80 East Calhoun LA 71225 78 08 1 None 1 2 2 32520200 92326764RUSTON CLINIC COMPANY LLC Langiulli Michael MD 3057 Hwy 80 West Calhoun LA 71225 20 06 1 none 1 2 2 32514100 92341500RUSTON CLINIC COMPANY LLC Nishat Arifa MD 3057 Hwy 80 West Calhoun LA 71225 20 08 1 None 1 2 2 32514100 92341500JACKSON PARISH HOSPITAL 804 Chatham Ave. Chatham LA 71226 79 94 1 none 1 2 2 32307300 92453400JACKSON PARISH HOSPITAL Kindrick Kim FNP 804 Chatham Ave. Chatham LA 71226 78 08 1 none 1 2 2 32307300 92453400JACKSON PARISH HOSPITAL Parkerson Paula MD 804 Chatham Ave. Chatham LA 71226 20 08 1 none 1 2 2 32307300 92453400SHELL FAMILY CHIROPRACTIC CLINIC Grant, IV Gordon Gregory 3219 Hwy 165N Monroe LA 71230 30 35 1 none 1 2 1 32248134 91584432RICHLAND PARISH HOSPITAL Albritton Corey MD 407 Cincinnati St. Delhi LA 71232 20 41 1 >=18 1 2 2 32453093 91493906RICHLAND PARISH HOSPITAL Gonzales Cesar MD 407 Cincinnati St. Delhi LA 71232 20 08 1 none 1 2 2 32453093 91493906RICHLAND PARISH HOSPITAL Ize-Iyamu Menoni MD 407 Cincinnati St. Delhi LA 71232 20 08 1 none 1 2 2 32453093 91493906RICHLAND PARISH HOSPITAL McDonald, III Kenneth MD 407 Cincinnati St. Delhi LA 71232 20 08 1 none 1 2 2 32453093 91493906RICHLAND PARISH HOSPITAL Mistry Fulvantiben MD 407 Cincinnati St. Delhi LA 71232 20 16 1 none 1 2 2 32453093 91493906RICHLAND PARISH HOSPITAL Parker Robert DO 407 Cincinnati St. Delhi LA 71232 19 08 1 none 1 2 2 32453093 91493906RICHLAND PARISH HOSPITAL Sparks Debbie FNP 407 Cincinnati St. Delhi LA 71232 78 08 1 none 1 2 2 32453093 91493906RICHLAND PARISH HOSPITAL Tucker Tyrone MD 407 Cincinnati St. Delhi LA 71232 20 08 1 none 1 2 2 32453093 91493906RICHLAND PARISH HOSPITAL Wagon Cynthia MD 407 Cincinnati St. Delhi LA 71232 20 41 1 >=18 1 2 1 32453093 91493906RICHLAND PARISH HOSPITAL Albritton Corey MD 508 Broadway St. Delhi LA 71232 20 41 1 >=18 1 2 2 32453092 91493050RICHLAND PARISH HOSPITAL Enriquez Jose MD 508 Broadway St. Delhi LA 71232 20 08 1 none 1 2 1 32453092 91493050RICHLAND PARISH HOSPITAL Grandon Paul MD 508 Broadway St. Delhi LA 71232 20 41 1 >=18 1 2 2 32453092 91493050RICHLAND PARISH HOSPITAL Harris Recel D. FNP 508 Broadway St. Delhi LA 71232 78 08 1 none 1 2 1 32453092 91493050RICHLAND PARISH HOSPITAL Hayden Benjamin NP 508 Broadway St. Delhi LA 71232 78 08 1 none 1 2 2 32453092 91493050RICHLAND PARISH HOSPITAL Hensley Rhonda NP 508 Broadway St. Delhi LA 71232 78 08 1 none 1 2 2 32453092 91493050RICHLAND PARISH HOSPITAL Le Dung N. MD 508 Broadway St. Delhi LA 71232 20 08 1 none 1 2 1 32453092 91493050RICHLAND PARISH HOSPITAL McDonald, III Kenneth MD 508 Broadway St. Delhi LA 71232 20 08 1 none 1 2 2 32453092 91493050RICHLAND PARISH HOSPITAL Sparks Debbie FNP 508 Broadway St. Delhi LA 71232 78 08 1 none 1 2 2 32453092 91493050RICHLAND PARISH HOSPITAL Tucker Tyrone MD 508 Broadway St. Delhi LA 71232 20 08 1 none 1 2 2 32453092 91493050RICHLAND PARISH HOSPITAL Wagon Cynthia MD 508 Broadway St. Delhi LA 71232 20 41 1 >=18 1 2 1 32453092 91493050RICHLAND PARISH HOSPITAL 508 Broadway Street Delhi LA 71232 60 86 1 none 1 2 1 32453092 91493050RICHLAND PARISH HOSPITAL 508 Broadway Street Delhi LA 71232 79 94 1 none 1 2 1 32453092 91493050MIDSOUTH ARTIFICIAL LIMB 903 Broadway St Delhi LA 71232 40 54 1 none 1 2 2 32447883 91492772UNION GENERAL HOSPITAL 1025 Marion Hwy Farmerville LA 71241 79 94 1 none 1 2 2 32788555 92390164HEALTH SERVICES OF NORTH LOUISIANA Corley Holly D. MD 1025 Marion Hwy Farmerville LA 71241 20 41 1 >=18 1 2 2 32788555 92390164GLENN FIGUEROA Figueroa Glenn MD 735 James Ave Ste B Farmerville LA 71241 20 41 1 >=18 1 2 2 32786256 92397302STEVE UNKEL Unkel Steven P. MD 811 James Ave Farmerville LA 71241 20 08 1 none 1 2 1 32786253 92395631STEVEN W. VENTERS, M.D., LLC Venters Steven W. MD 811 James Ave. Suite B Farmerville LA 71241 20 41 1 >=18 1 2 1 32786253 92395631UNION GENERAL HOSPITAL 901 James Ave Farmerville LA 71241 60 86 1 none 1 2 2 32786271 92393845RUSTON CLINIC COMPANY LLC Gwan Ofundem R. MD 4633 Quitman Highway Hodge LA 71247 20 41 1 >=18 1 2 2 32269046 92724296RUSTON CLINIC COMPANY LLC Lacayo Leonel MD 4633 Quitman Highway Hodge LA 71247 20 10 1 none 1 2 2 32269046 92724296RUSTON CLINIC COMPANY LLC Langiulli Michael MD 4633 Quitman Highway Hodge LA 71247 20 06 1 none 1 2 2 32269046 92724296JACKSON PARISH HOSPITAL Edu Jenny FNP 121 Watts St Stes. E & F Jonesboro LA 71251 78 08 1 none 1 2 1 32252784 92721040JACKSON PARISH HOSPITAL 121 Watts St. Stes. E & F Jonesboro LA 71251 79 94 1 none 1 2 2 32252784 92721040JACKSON PARISH HOSPITAL Overby John MD 121 Watts St. Stes. E & F Jonesboro LA 71251 20 08 1 none 1 2 2 32252784 92721040JACKSON PARISH HOSPITAL 165 Beach Springs Rd. Jonesboro LA 71251 60 86 1 none 1 2 2 32252487 92713835MEDICAL ASSOC OF NORTHEAST LA Mouhaffel Assad H. 165 Beech Springs Rd Jackson Parish HospitJonesboro LA 71251 20 06 1 >=18 1 2 1 32252487 92713835JACKSON PARISH HOSPITAL Hattaway Lizabeth FNP 165 Beech Springs Rd. Jonesboro LA 71251 78 08 1 none 1 2 2 32252487 92713835JACKSON PARISH HOSPITAL White Gordon MD 165 Beech Springs Rd. Jonesboro LA 71251 20 08 1 none 1 2 2 32252487 92713835KUSHAL AGARWAL Agarwal Kushal C. MD 510 Alexander St Jonesboro LA 71251 20 41 1 >=18 1 2 1 32254029 92722632HEALTH SERVICES OF NORTH LOUISIANA 226 North Hood Street Lake Providence LA 71254 60 86 1 none 1 2 2 32808450 91171571HEALTH SERVICES OF NORTH LOUISIANA Bailey Don W. MD 300 Scarborough Lake Providence LA 71254 20 08 1 None 1 2 1 32803390 91171464GANDY EYE CARE Gandy Stacy G. OD 311 Lake St Lake Providence LA 71254 28 88 1 none 1 2 1 32805523 91172351


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

GANDY EYE CARE Gandy Jimmy S. OD 311 Lake St. Lake Providence LA 71254 28 88 1 none 1 2 1 32805523 91172351HEALTH SERVICES OF NORTH LOUISIANA Simon Llewellyn L. MD 320 North Hood Street Lake Providence LA 71254 20 41 1 >=18 1 2 2 32810758 91171547HEALTH SERVICES OF NORTH LOUISIANA Perkins Camille E. MD 326 North Hood Street Lake Providence LA 71254 20 37 1 <=18 1 2 1 32810867 91171527RICHARDSON MEDICAL CENTER Morgan Ronald J. 107 Lela St Mangham LA 71259 20 08 1 None 1 2 2 32311042 91784558MIDSOUTH MEDICAL EQUIPMENT 254 LA Highway 132 Mangham LA 71259 40 54 1 none 1 2 2 32306500 91775000RICHARDSON MEDICAL CENTER Abraham Ralph PO Box 219 Mangham LA 71259 20 02 1 none 1 2 1 32351294 91809201UNION GENERAL HOSPITAL 3150 Taylor St Marion LA 71260 79 94 1 none 1 2 2 32902784 92242220MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. 108 N. 16th St Mer Rouge LA 71261 72 9L 1 none 1 2 1 32775700 91793100MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. Boyte James S. FND 108 N. 16th St Mer Rouge LA 71261 78 08 1 None 1 2 1 32775700 91793100MOREHOUSE COMMUNITY MEDICAL CENTERS, INC. Wood Teresa A. FNP 108 N. 16th St Mer Rouge LA 71261 78 08 1 None 1 2 2 32775700 91793100FAMILY MEDICAL CLINIC Webb Wyatt MD 205 Davenport Ave Mer Rouge LA 71261 20 08 1 None 1 2 2 32774986 91791354ALLEN L SPIRES MD APMC Spires Allen L. MD 301 Davenport Ave Mer Rouge LA 71261 20 08 1 none 1 2 1 32776800 91795000RICHARDSON MEDICAL CENTER 1012 Louisa St Rayville LA 71269 79 94 1 none 1 2 1 32468666 91758624RICHARDSON MEDICAL CENTER Dunn David H. 1012 Louisa St Rayville LA 71269 20 16 1 >=16 1 2 1 32468666 91758624RICHARDSON MEDICAL CENTER Lafleur Dan J. 1012 Louisa St Rayville LA 71269 20 08 1 None 1 2 1 32468666 91758624RICHARDSON MEDICAL CENTER Ponarski Roland 1012 Louisa St Rayville LA 71269 20 41 1 >=18 1 2 1 32468666 91758624RICHARDSON MEDICAL CENTER Thompson William D. 1012 Louisa St Rayville LA 71269 20 08 1 None 1 2 1 32468666 91758624GANDY EYE CARE Gandy Stacy G. OD 107 Maxwell St Rayville LA 71269 28 88 1 none 1 2 1 32459494 91757607GANDY EYE CARE Gandy Jimmy S. OD 107 Maxwell St. Rayville LA 71269 28 88 1 none 1 2 1 32459494 91757607RICHARDSON MEDICAL CENTER Massengale Gordon B. 111 Christian Dr Rayville LA 71269 20 08 1 None 1 2 2 32459846 91758245RICHARDSON MEDICAL CENTER Kerr Albert 121 Christian Drive Rayville LA 71269 20 08 1 None 1 2 1 32459846 91758245RICHARDSON MEDICAL CENTER Hubbard Ronald C. 129 Christian Dr Rayville LA 71269 20 41 1 >=18 1 2 2 32459766 91758042United Home Care, Inc. 150 Christian Drive Rayville LA 71269 20 37 1 none 1 2 1 32459938 91757770MONROE CARDIOVASCULAR ASSOCIATES Chaudry Imaran T. 161 Christian Dr Rayville LA 71269 20 06 1 none 1 2 1 32459510 91757590RICHARDSON MEDICAL CENTER Chaudry Imran I. 161 Christian Dr Rayville LA 71269 20 41 1 >=18 1 2 1 32459510 91757590RAYVILLE FAMILY CLINIC Tebbe, Jr. James MD 1962 Julia St. Rayville LA 71269 20 08 1 none 1 2 1 32461641 91759218RAYVILLE FAMILY CLINIC Walton Audrey A. APRN 1962 Julia St. Rayville LA 71269 78 08 1 none 1 2 2 32461641 91759218RAYVILLE FAMILY CLINIC Sylvestri Terri APRN 1962 Julia Street Rayville LA 71269 78 08 1 none 1 2 1 32461641 91759218RICHARDSON MEDICAL CENTER 254 Hwy 3048 Rayville LA 71269 60 86 1 none 1 2 2 32457812 91738597RICHARDSON MEDICAL CENTER Thompson Addison D. 284 Hwy 3048 Rayville LA 71269 20 02 1 none 1 2 1 32457016 91737361RICHARDSON MEDICAL CENTER Maddox Dale R. 87 Sullivan Loop Rayville LA 71269 20 08 1 None 1 2 2 32469883 91869061RICHARDSON MEDICAL CENTER Krier Brian P. P.O. Box 1164 Rayville LA 71269 20 08 1 None 1 2 2 32463868 91663939RICHARDSON MEDICAL CENTER Ardoin Shannon E. P.O. Box 66 Rayville LA 71269 20 30 1 none 1 2 2 32480267 91761588RICHARDSON MEDICAL CENTER Armington William G. P.O. Box 66 Rayville LA 71269 20 30 1 none 1 2 2 32480267 91761588RICHARDSON MEDICAL CENTER Brown Edward L. P.O. Box 66 Rayville LA 71269 20 30 1 none 1 2 1 32480267 91761588RICHARDSON MEDICAL CENTER Edwards Robert L. P.O. Box 66 Rayville LA 71269 20 30 1 none 1 2 2 32480267 91761588RICHARDSON MEDICAL CENTER Fontanez Daniel G. P.O. Box 66 Rayville LA 71269 20 30 1 none 1 2 2 32480267 91761588RICHARDSON MEDICAL CENTER Henry Wayne H. P.O. Box 66 Rayville LA 71269 20 30 1 none 1 2 2 32480267 91761588RICHARDSON MEDICAL CENTER Marcantel Kara B. P.O. Box 66 Rayville LA 71269 20 30 1 none 1 2 1 32480267 91761588RICHARDSON MEDICAL CENTER Smith Stover L. P.O. Box 66 Rayville LA 71269 20 30 1 none 1 2 2 32480267 91761588RICHARDSON MEDICAL CENTER Yatco Reynaldo L. P.O. Box 66 Rayville LA 71269 20 30 1 none 1 2 1 32480267 91761588DILLINGHAM OPTICAL OF RUSTON 1010 South Virginia Ruston LA 71270 75 88 1 none 1 2 2 32525369 92660452JANS OPTICAL LLC Houck Jan 104 North Monroe Ruston LA 71270 28 88 1 none 1 2 2 32528914 92640506SAMARITAN HOME MEDICAL EQUIPMENT 112 S. Trenton Street Ruston LA 71270 40 54 1 none 1 2 2 32527187 92639228RUSTON CLINIC COMPANY LLC Batson Jerry NP 1809 Northpoint Lane, Suite 102 Ruston LA 71270 78 08 1 none 1 2 2 32537300 92640200RUSTON CLINIC COMPANY LLC Langiulli Dayanny MD 1809 Northpointe Lane, Ste. 101 Ruston LA 71270 20 37 1 <=18 1 2 2 32537300 92640200RUSTON CLINIC COMPANY LLC Zuckerman Victor MD 1809 Northpointe Lane, Ste. 101 Ruston LA 71270 20 37 1 <=18 1 2 2 32537300 92640200RUSTON CLINIC COMPANY LLC Byrd Jennifer FNP 1809 Northpointe Lane, Ste. 102 Ruston LA 71270 78 08 1 >=18 1 2 2 32537300 92640200RUSTON CLINIC COMPANY LLC Conville Stacy MD 1809 Northpointe Lane, Ste. 102 Ruston LA 71270 20 08 1 None 1 2 2 32537300 92640200RUSTON CLINIC COMPANY LLC Hardy Angela FNP 1809 Northpointe Lane, Ste. 102 Ruston LA 71270 78 08 1 >=18 1 2 2 32537300 92640200


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

RUSTON CLINIC COMPANY LLC McGovern Patricia FNP 1809 Northpointe Lane, Ste. 102 Ruston LA 71270 78 08 1 >=18 1 2 1 32537300 92640200RUSTON CLINIC COMPANY LLC Williams Angela FNP 1809 Northpointe Lane, Ste. 102 Ruston LA 71270 78 08 1 >=18 1 2 2 32537300 92640200RUSTON CLINIC COMPANY LLC McIntyre Brenda MD 206 E. Reynolds Dr., Ste. C3 Ruston LA 71270 20 37 1 <=18 1 2 1 32543094 92637462SYNERGY HOME CARE-NORTHEASTERN REGION, INC 2201 N. Service Road Ruston LA 71270 44 75 1 none 1 2 2 32540889 92610984VINCENT JARED M MD Vincent Jared M. 400 E. Vaughn Ave Ruston LA 71270 20 18 1 none 1 2 1 32515151 92633849Ruston LA Hospital Corp LLC, dba NLMC 401 E. Vaugh Ruston LA 71270 60 86 1 none 1 2 2 32583655 92536532KUSHAL AGARWAL Agarwal Kushal C. MD 411 E. Vaughn Ste 102 Ruston LA 71270 20 41 1 >=18 1 2 1 32515454 92633783RUSTON CLINIC COMPANY LLC Blair Major E. MD 411 East Vaughn Avenue Suite 201 Ruston LA 71270 20 20 1 none 1 2 2 32515454 92633783RUSTON CLINIC COMPANY LLC DiStante Brian T. MD 411 East Vaughn Avenue Suite 105 Ruston LA 71270 20 02 1 none 1 2 2 32515454 92633783RUSTON CLINIC COMPANY LLC Jones Cynthia M. MD 411 East Vaughn Avenue Suite 200 Ruston LA 71270 20 02 1 none 1 2 2 32515454 92633783RUSTON CLINIC COMPANY LLC Lacayo Leonel MD 411 East Vaughn Avenue Suite 205 Ruston LA 71270 20 10 1 none 1 2 2 32515454 92633783RUSTON CLINIC COMPANY LLC Langiulli Michael MD 411 East Vaughn Avenue Suite 105 Ruston LA 71270 20 06 1 none 1 2 2 32515454 92633783RUSTON CLINIC COMPANY LLC Larson Cynthia E. MD 411 East Vaughn Avenue Suite 202 Ruston LA 71270 20 16 1 >=16 1 2 1 32515454 92633783RUSTON CLINIC COMPANY LLC Meyer JoAnn MD 411 East Vaughn Avenue Suite 206 Ruston LA 71270 20 18 1 none 1 2 2 32515454 92633783RUSTON CLINIC COMPANY LLC Meyer Kevin MD 411 East Vaughn Avenue Suite 206 Ruston LA 71270 20 02 1 none 1 2 2 32515454 92633783RUSTON CLINIC COMPANY LLC Murray Howard N. MD 411 East Vaughn Avenue Suite 101 Ruston LA 71270 20 29 1 none 1 2 2 32515454 92633783RUSTON CLINIC COMPANY LLC Rutland Edward H. MD 411 East Vaughn Avenue Suite 100 Ruston LA 71270 20 34 1 none 1 2 2 32515454 92633783RUSTON CLINIC COMPANY LLC Smith Landon C. MD 411 East Vaughn Avenue Suite 103 Ruston LA 71270 20 16 1 >=16 1 2 1 32515454 92633783United Home Care, Inc. 608 Belue Street Ruston LA 71270 20 37 1 none 1 2 1 32537300 92640200LINCARE INC 610 S TRENTON ST RUSTON LA 71270 40 54 1 none 1 1 2 32521864 92639595LINCARE INC 610 Trenton St Ruston LA 71270 40 54 1 none 1 2 1 32534615 92638722VISION ASSOCIATES, INC. Eaton Jim N. OD 911 Tech Drive Ruston LA 71270 28 88 1 none 1 2 1 32530100 92652000WOMANS CLINIC OF MONROE Belsom William B. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 2 32537707 92639082WOMANS CLINIC OF MONROE Bryan David G. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 2 32537707 92639082WOMANS CLINIC OF MONROE Clark Dellie H. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 2 32537707 92639082WOMANS CLINIC OF MONROE Hall Peyton R. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 2 32537707 92639082WOMANS CLINIC OF MONROE Jackson Gwenn V. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 1 32537707 92639082WOMANS CLINIC OF MONROE Jopling Annie G. 931 North Trenton St. Ruston LA 71270 78 16 1 >=16 1 2 1 32537707 92639082WOMANS CLINIC OF MONROE Klug Sara 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 2 32537707 92639082WOMANS CLINIC OF MONROE LeBleu Vaszily Laurie R. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 1 32537707 92639082WOMANS CLINIC OF MONROE Lee Won S. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 1 32537707 92639082WOMANS CLINIC OF MONROE Pennebaker Dawn W. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 1 32537707 92639082WOMANS CLINIC OF MONROE Peveto Sherry S. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 1 32537707 92639082WOMANS CLINIC OF MONROE Salas Amber M. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 1 32537707 92639082WOMANS CLINIC OF MONROE Sheppard Tonya H. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 2 32537707 92639082WOMANS CLINIC OF MONROE Tugwell Terence R. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 2 32537707 92639082WOMANS CLINIC OF MONROE Walters Christie J. 931 North Trenton St. Ruston LA 71270 78 16 1 >=16 1 2 2 32537707 92639082WOMANS CLINIC OF MONROE Williams Adrienne M. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 2 32537707 92639082WOMANS CLINIC OF MONROE Wilson Jason B. 931 North Trenton St. Ruston LA 71270 20 16 1 >=16 1 2 1 32537707 92639082STERLINGTON HEALTH CLINIC 10374 Hwy 165 Suite B Sterlington LA 71280 20 08 1 None 1 2 1 32695177 92024054STERLINGTON HEALTH CLINIC Fletcher Kimberly FNP 10374 Hwy 165 Suite B Sterlington LA 71280 78 08 1 none 1 2 1 32695177 92024054STERLINGTON HEALTH CLINIC Lipka John M. MD 10374 Hwy 165 Suite B Sterlington LA 71280 20 08 1 none 1 2 1 32695177 92024054MADISON HIGH SCHOOL BASED HEALTH CENTER 1234 Madison High Drive Tallulah LA 71282 78 08 1 None 1 2 1 32385600 91177600MADISON HIGH SCHOOL BASED HEALTH CENTER Chenier Lawrence F. MD 1234 Madison High Drive Tallulah LA 71282 20 08 1 None 1 2 1 32385600 91177600MADISON HIGH SCHOOL BASED HEALTH CENTER Redd Sylvia F. NP 1234 Madison High Drive South Tallulah LA 71282 78 08 1 >=18 1 2 2 32385600 91177600HEALTH SERVICES OF NORTH LOUISIANA Neumann Thomas A. MD 212 S Chestnut St Tallulah LA 71282 20 08 1 None 1 2 2 32407162 91189005HEALTH SERVICES OF NORTH LOUISIANA Neumann Leonard P. MD 800 Johnson St Tallulah LA 71282 20 41 1 >=18 1 2 2 32404426 91186046OUTPATIENT MEDICAL CENTER INC 804 Beech St Tallulah LA 71282 72 9L 1 none 1 2 2 32409216 91181540OUTPATIENT MEDICAL CENTER INC Matta Anil S. MD 804 Beech St Tallulah LA 71282 20 08 1 none 1 2 1 32409216 91181540OUTPATIENT MEDICAL CENTER INC Perry Donald R. MD 804 Beech St Tallulah LA 71282 20 08 1 none 1 2 1 32409216 91181540


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

OUTPATIENT MEDICAL CENTER INC Wyche Ronald C. MD 804 Beech St Tallulah LA 71282 20 08 1 none 1 2 1 32409216 91181540HEALTH SERVICES OF NORTH LOUISIANA 900 Johnson Street Tallulah LA 71282 60 86 1 none 1 2 2 32403553 91185586CUSTOM HEALTHCARE INC Callahan Mike E. 1011 North 7th St. Suite 1 West Monroe LA 71291 40 54 1 none 1 2 2 32504161 92136875MEDICAL ASSOC OF NORTHEAST LA 102 Thomas Rd Ste 103 West Monroe LA 71291 20 06 1 none 1 2 2 32517141 92157439MARIE'S MEDICAL SUPPLY 102 Thomas Rd Ste 605 West Monroe LA 71291 40 54 1 none 1 2 1 32517141 92157439RICHARDSON MEDICAL CENTER Coon Clayton C. 102 Thomas Rd Ste 506 West Monroe LA 71291 20 10 1 none 1 2 2 32517141 92157439RICHARDSON MEDICAL CENTER McHugh Johnny B. MD 102 Thomas Rd Ste 506 West Monroe LA 71291 20 41 1 >=18 1 2 2 32517141 92157439MEDICAL ASSOC OF NORTHEAST LA Mouhaffel Assad H. 102 Thomas Rd Ste 103 West Monroe LA 71291 20 06 1 >=18 1 2 1 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA Roy Samer N. MD 102 Thomas Rd West Monroe LA 71291 20 41 1 >=18 1 2 2 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA Beene Stephen MD 102 Thomas Rd, Suite 113 West Monroe LA 71291 20 41 1 >=18 1 2 2 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA Caskey David M. MD 102 Thomas Rd, Suite 400 West Monroe LA 71291 20 06 1 none 1 2 2 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA Koepke Ronald P. MD 102 Thomas Rd, Suite 400 West Monroe LA 71291 20 06 1 none 1 2 2 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA Perkins Ronald A. NP 102 Thomas Rd, Suite 400 West Monroe LA 71291 78 08 1 >=18 1 2 2 32517141 92157439AFFINITY HEALTH GROUP LLC Caskey, Jr. David M. 102 Thomas Rd. West Monroe LA 71291 20 06 1 none 1 2 2 32517141 92157439AFFINITY HEALTH GROUP LLC Ferguson William 102 Thomas Rd. Ste. 205 West Monroe LA 71291 20 02 1 none 1 2 2 32517141 92157439AFFINITY HEALTH GROUP LLC Koepke Ronald Paul 102 Thomas Rd. West Monroe LA 71291 20 06 1 none 1 2 2 32517141 92157439PHYSICIAN GROUP OF LOUISIANA Beene Stephen MD 102 Thomas Rd., #113 West Monroe LA 71291 20 41 1 >=18 1 2 2 32517141 92157439PHYSICIAN GROUP OF LOUISIANA Badi Arun MD 102 Thomas Rd., #202 West Monroe LA 71291 20 04 1 none 1 2 1 32517141 92157439PHYSICIAN GROUP OF LOUISIANA Crooks Emily NP 102 Thomas Rd., Ste. 104 West Monroe LA 71291 78 79 1 >=18 1 2 2 32517141 92157439PHYSICIAN GROUP OF LOUISIANA Hammett Ronald F. MD 102 Thomas Rd., Ste. 104 West Monroe LA 71291 20 29 1 none 1 2 2 32517141 92157439PHYSICIAN GROUP OF LOUISIANA Boykin Michael MD 102 Thomas Rd., Ste. 107 West Monroe LA 71291 20 13 1 none 1 2 2 32517141 92157439P THOMAS CAUSEY JR MD AMC Causey, Jr. P. Thomas MD 102 Thomas Rd., Ste. 201 West Monroe LA 71291 20 06 1 none 1 2 2 32517141 92157439P THOMAS CAUSEY JR MD AMC Fuller Nicole M. APRN, FNP-C102 Thomas Rd., Ste. 201 West Monroe LA 71291 78 08 1 None 1 2 2 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA Thompson Lowery L. MD 102 Thomas Road, Suite 107 West Monroe LA 71291 20 13 1 none 1 2 2 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA Bimle Cynthia Petrus MD 102 Thomas Road, Suite 202 West Monroe LA 71291 20 37 1 <=18 1 2 1 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA Ferguson William T. MD 102 Thomas Road, Suite 205 West Monroe LA 71291 20 02 1 none 1 2 2 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA Coon Clayton C. MD 102 Thomas Road, Suite 506 West Monroe LA 71291 20 10 1 none 1 2 2 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA McHugh Johnny B. MD 102 Thomas Road, Suite 506 West Monroe LA 71291 20 10 1 none 1 2 2 32517141 92157439HEALTH SERVICES OF NORTH LOUISIANA Broyles Michael O. MD 105-B McMillan West Monroe LA 71291 20 30 1 none 1 2 1 32516213 92148101HEALTH SERVICES OF NORTH LOUISIANA Green Warren J. MD 105-B McMillan West Monroe LA 71291 20 30 1 none 1 2 2 32516213 92148101HEALTH SERVICES OF NORTH LOUISIANA Hollenberg Henry G. MD 105-B McMillan West Monroe LA 71291 20 30 1 none 1 2 1 32516213 92148101HEALTH SERVICES OF NORTH LOUISIANA Yatco Reynaldo L. MD 105-B McMillan West Monroe LA 71291 20 30 1 none 1 2 1 32516213 92148101DANNA LAWRENCE JMD Danna Lawrence J. MD 108 Contempo Ave West Monroe LA 71291 20 04 1 none 1 2 1 32514763 92151589LABCORP 109 CIRCLE DR WEST MONROE LA 71291 20 30 1 none 1 1 2 32516991 92153261BAYOU PATHOLOGY APMC Armstrong, III John M. 109 Circle Dr West Monroe LA 71291 20 22 1 none 1 2 1 32516991 92153261BAYOU PATHOLOGY APMC Elias Abdalla L. 109 Circle Dr West Monroe LA 71291 20 22 1 none 1 2 1 32516991 92153261RICHARDSON MEDICAL CENTER Maxwell John E. 109 Circle Dr West Monroe LA 71291 20 22 1 none 1 2 2 32516991 92153261RICHARDSON MEDICAL CENTER Pankey Lee R. 109 Circle Dr West Monroe LA 71291 20 22 1 none 1 2 1 32516991 92153261BAYOU PATHOLOGY APMC Maxwell, II John E. 109 Circle Dr. West Monroe LA 71291 20 22 1 none 1 2 1 32516991 92153261BAYOU PATHOLOGY APMC Pankey Lee R. 109 Circle Dr. West Monroe LA 71291 20 22 1 none 1 2 1 32516991 92153261BAYOU PATHOLOGY APMC Smith Nancy V. 109 Circle Dr. West Monroe LA 71291 20 22 1 none 1 2 2 32516991 92153261RICHARDSON MEDICAL CENTER Armstrong John M. 109 Circle Drive West Monroe LA 71291 20 22 1 none 1 2 1 32516991 92153261RICHARDSON MEDICAL CENTER Elias Abdalla L. 109 Circle Drive West Monroe LA 71291 20 22 1 none 1 2 1 32516991 92153261AFFINITY HEALTH GROUP LLC Blackmon Charles D. 109 Regency Place West Monroe LA 71291 20 08 1 none 1 2 1 32513149 92144927AFFINITY HEALTH GROUP LLC Coleman Edward O. 109 Regency Place West Monroe LA 71291 19 08 1 none 1 2 2 32513149 92144927AFFINITY HEALTH GROUP LLC Jones Patrick Gary 109 Regency Place West Monroe LA 71291 20 08 1 none 1 2 2 32513149 92144927HEALTH SERVICES OF NORTH LOUISIANA McMahan Steven H. MD 1117 Cheniere Drew Road West Monroe LA 71291 20 08 1 None 1 2 2 32543354 92245533MAYFIELD FAST SERV MEDICAL OF MONROE 112 Summer Lane West Monroe LA 71291 40 54 1 none 1 2 2 32513486 92180310HEALTH SERVICES OF NORTH LOUISIANA Dollar Mark F. MD 122 Professional Dr West Monroe LA 71291 20 08 1 None 1 2 2 32515032 92150467HEALTH SERVICES OF NORTH LOUISIANA Sanson Marshall Vashon MD 122 Professional Drive West Monroe LA 71291 20 08 1 None 1 2 2 32515032 92150467


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

OPTICAL WEST INC 1801 North 7th West Monroe LA 71291 75 88 1 none 1 2 2 32511305 92146082RICHARDSON MEDICAL CENTER Haik Raymond E. 1804 North 7th St West Monroe LA 71291 20 18 1 none 1 2 2 32511534 92145900HEALTH SERVICES OF NORTH LOUISIANA Baber Wilson Bloomfield MD 1804 North 7th Street West Monroe LA 71291 20 18 1 none 1 2 2 32511534 92145900HEALTH SERVICES OF NORTH LOUISIANA Gosslee Jeffrey M. MD 1804 North 7th Street West Monroe LA 71291 20 18 1 none 1 2 2 32511534 92145900HEALTH SERVICES OF NORTH LOUISIANA Haik Raymond E. MD 1804 North 7th Street West Monroe LA 71291 20 18 1 none 1 2 2 32511534 92145900HEALTH SERVICES OF NORTH LOUISIANA Humble Joseph E. MD 1804 North 7th Street West Monroe LA 71291 20 18 1 none 1 2 2 32511534 92145900HEALTH SERVICES OF NORTH LOUISIANA Parker Thomas Guy MD 1804 North 7th Street West Monroe LA 71291 20 18 1 none 1 2 2 32511534 92145900HEALTH SERVICES OF NORTH LOUISIANA Williamson Baron James MD 1804 North 7th Street West Monroe LA 71291 20 18 1 none 1 2 2 32511534 92145900HEALTH SERVICES OF NORTH LOUISIANA McCormick Michael E. MD 1900 North 7th Street West Monroe LA 71291 20 08 1 None 1 2 2 32512335 92146830Ouachita Parish School Board Bimle Cynthia P. MD 201 Riggs St West Monroe LA 71291 20 37 1 <=18 1 2 1 32512261 92138632Ouachita Parish School Board Hamilton Laurie 201 Riggs St West Monroe LA 71291 78 08 1 None 1 2 2 32512261 92138632Ouachita Parish School Board 201 Riggs Street West Monroe LA 71291 20 08 1 None 1 2 1 32512261 92138632Ouachita Parish School Board Beauregard Wilbur G. MD 201 Riggs Street West Monroe LA 71291 20 37 1 <=18 1 2 2 32512261 92138632Ouachita Parish School Board Parker Tammy 201 Riggs Street West Monroe LA 71291 78 08 1 None 1 2 2 32512261 92138632GLENN FIGUEROA Figueroa Glenn MD 206 McMillan Rd Ste 1 West Monroe LA 71291 20 41 1 >=18 1 2 2 32515684 92150373HANGER PROSTHETICS AND ORTHOTICS 3007 Cypress St West Monroe LA 71291 40 53 1 none 1 2 1 32517147 92152873HANGER PROSTHETICS AND ORTHOTICS 3007 Cypress Street West Monroe LA 71291 40 53 1 none 1 2 1 32517147 92152873WOMANS CLINIC OF MONROE Belsom William B. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32514924 92151333WOMANS CLINIC OF MONROE Bryan David G. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32514924 92151333WOMANS CLINIC OF MONROE Clark Dellie H. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32514924 92151333WOMANS CLINIC OF MONROE Hall Peyton R. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32514924 92151333WOMANS CLINIC OF MONROE Jackson Gwenn V. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32514924 92151333WOMANS CLINIC OF MONROE Jopling Annie G. 301 McMillan Rd West Monroe LA 71291 78 16 1 >=16 1 2 1 32514924 92151333WOMANS CLINIC OF MONROE Klug Sara 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32514924 92151333WOMANS CLINIC OF MONROE LeBleu Vaszily Laurie R. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32514924 92151333WOMANS CLINIC OF MONROE Lee Won S. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32514924 92151333WOMANS CLINIC OF MONROE Pennebaker Dawn W. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32514924 92151333WOMANS CLINIC OF MONROE Peveto Sherry S. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32514924 92151333WOMANS CLINIC OF MONROE Salas Amber M. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32514924 92151333WOMANS CLINIC OF MONROE Sheppard Tonya H. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32514924 92151333WOMANS CLINIC OF MONROE Tugwell Terence R. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32514924 92151333WOMANS CLINIC OF MONROE Walters Christie J. 301 McMillan Rd West Monroe LA 71291 78 16 1 >=16 1 2 2 32514924 92151333WOMANS CLINIC OF MONROE Williams Adrienne M. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32514924 92151333WOMANS CLINIC OF MONROE Wilson Jason B. 301 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32514924 92151333BLACKMON LARRY E OD Blackmon Larry E. OD 303 McMillan Rd. West Monroe LA 71291 28 88 1 none 1 2 2 32514924 92151333LINDA BUNCH, MD Bunch Linda MD 3602 Cypress St Ste A West Monroe LA 71291 20 41 1 >=18 1 2 2 32517406 92162653YEAGER M DWAYNE OD Yeager M. Dwayne OD, FAAO 3805 Cypress St. West Monroe LA 71291 28 88 1 none 1 2 2 32517077 92168429CARDIOVASCULAR DIAGNOSTIC CENTER Gonzalez Virginia MD 402 McMillan Rd. West Monroe LA 71291 20 06 1 none 1 2 2 32514228 92153593CARDIOVASCULAR DIAGNOSTIC CENTER Smith Brenda FNP 402 McMillan Rd. West Monroe LA 71291 78 08 1 >=18 1 2 2 32514228 92153593WOMANS CLINIC OF MONROE Belsom William B. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32513892 92153667WOMANS CLINIC OF MONROE Bryan David G. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32513892 92153667WOMANS CLINIC OF MONROE Clark Dellie H. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32513892 92153667WOMANS CLINIC OF MONROE Hall Peyton R. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32513892 92153667WOMANS CLINIC OF MONROE Jackson Gwenn V. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32513892 92153667WOMANS CLINIC OF MONROE Jopling Annie G. 417 McMillan Rd West Monroe LA 71291 78 16 1 >=16 1 2 1 32513892 92153667WOMANS CLINIC OF MONROE Klug Sara 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32513892 92153667WOMANS CLINIC OF MONROE LeBleu Vaszily Laurie R. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32513892 92153667WOMANS CLINIC OF MONROE Lee Won S. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32513892 92153667WOMANS CLINIC OF MONROE Pennebaker Dawn W. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32513892 92153667WOMANS CLINIC OF MONROE Peveto Sherry S. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32513892 92153667


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

WOMANS CLINIC OF MONROE Salas Amber M. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32513892 92153667WOMANS CLINIC OF MONROE Sheppard Tonya H. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32513892 92153667WOMANS CLINIC OF MONROE Tugwell Terence R. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32513892 92153667WOMANS CLINIC OF MONROE Walters Christie J. 417 McMillan Rd West Monroe LA 71291 78 16 1 >=16 1 2 2 32513892 92153667WOMANS CLINIC OF MONROE Williams Adrienne M. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 2 32513892 92153667WOMANS CLINIC OF MONROE Wilson Jason B. 417 McMillan Rd West Monroe LA 71291 20 16 1 >=16 1 2 1 32513892 92153667MEDICAL ASSOC OF NORTHEAST LA 503 McMillan Rd Glenwood Hosp West Monroe LA 71291 20 06 1 none 1 2 2 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA Allen Kim S. NP 503 McMillan Rd West Monroe LA 71291 78 08 1 >=18 1 2 2 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA Donias Harry W. MD 503 McMillan Rd West Monroe LA 71291 20 33 1 none 1 2 2 32513320 92155245MEDICAL ASSOC OF NORTHEAST LA Mouhaffel Assad H. 503 McMillan Rd Glenwood Hosp West Monroe LA 71291 20 06 1 >=18 1 2 1 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA Wooten Melissa R. NP 503 McMillan Rd West Monroe LA 71291 78 08 1 >=18 1 2 2 32513320 92155245GLENWOOD REGIONAL MEDICAL CENTER 503 McMillan Rd. West Monroe LA 71291 35 65 1 none 1 2 1 32513320 92155245GLENWOOD REGIONAL MEDICAL CENTER 503 McMillan Rd. West Monroe LA 71291 60 86 1 none 1 2 1 32513320 92155245PHYSICIAN GROUP OF LOUISIANA Donias Harry MD 503 McMillan Rd. West Monroe LA 71291 20 33 1 none 1 2 2 32513320 92155245PHYSICIAN GROUP OF LOUISIANA Nagem Edmund MD 503 McMillan Rd. West Monroe LA 71291 20 33 1 none 1 2 2 32513320 92155245PHYSICIAN GROUP OF LOUISIANA Sinclair Karen NP 503 McMillan Rd. West Monroe LA 71291 78 79 1 >=18 1 2 2 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA Boykin Michael E. MD 503 McMillan Road West Monroe LA 71291 20 13 1 none 1 2 2 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA Calhoun Jennifer L. NP 503 McMillan Road West Monroe LA 71291 78 08 1 >=18 1 2 2 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA Dona Grant Arthur MD 503 McMillan Road West Monroe LA 71291 20 20 1 none 1 2 2 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA Hammett Ronald F. MD 503 McMillan Road West Monroe LA 71291 20 29 1 none 1 2 2 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA McCormick Shelly C. MD 503 McMillan Road West Monroe LA 71291 20 37 1 <=18 1 2 1 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA Shelton Debra A. NP 503 McMillan Road West Monroe LA 71291 78 08 1 >=18 1 2 2 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA Wood Delores M. NP 503 McMillan Road West Monroe LA 71291 78 08 1 >=18 1 2 2 32513320 92155245HEALTH SERVICES OF NORTH LOUISIANA Hammett Donald K. MD 6198 Cypress Street, Bldg. 3 West Monroe LA 71291 20 41 1 >=18 1 2 2 32514196 92203340HEALTH SERVICES OF NORTH LOUISIANA Gullapalli Aruna MD 6200 Cypress Street West Monroe LA 71291 20 13 1 none 1 2 1 32514039 92203629Ouachita Parish School Board Hamilton Laurie 100 Price Dr West Monroe LA 71292 78 08 1 None 1 2 2 32487110 92175536Ouachita Parish School Board 100 Price Drive West Monroe LA 71292 20 08 1 None 1 2 1 32487110 92175536Ouachita Parish School Board Beauregard Wilbur G. MD 100 Price Drive West Monroe LA 71292 20 37 1 <=18 1 2 2 32487110 92175536Ouachita Parish School Board Bimle Cynthia P. MD 100 Price Drive West Monroe LA 71292 20 37 1 <=18 1 2 1 32487110 92175536Ouachita Parish School Board Parker Tammy 100 Price Drive West Monroe LA 71292 78 08 1 None 1 2 2 32487110 92175536HEALTHCARE WAREHOUSE LLC 209 Expo Circle, Ste. A West Monroe LA 71292 40 54 1 none 1 2 1 32498500 92154800United Home Care, Inc. 213 Expo Circle West Monroe LA 71292 20 37 1 none 1 2 1 32498500 92154800HEALTH SERVICES OF NORTH LOUISIANA Baldwin Vernon T. MD 2104 E Loop Rd Winnsboro LA 71295 20 08 1 None 1 2 1 32158886 91705396LABCORP 2106 LOOP RD WINNSBORO LA 71295 20 30 1 none 1 1 2 32158886 91705396HEALTH SERVICES OF NORTH LOUISIANA Eldridge Joel G. DO 2106 Loop Rd Winnsboro LA 71295 19 1T 1 none 1 2 2 32158886 91705396HEALTH SERVICES OF NORTH LOUISIANA 2106 Loop Road Winnsboro LA 71295 60 86 1 none 1 2 2 32158886 91705396HEALTH SERVICES OF NORTH LOUISIANA Colvin Thomas L. MD 2106A Loop Rd Winnsboro LA 71295 20 08 1 None 1 2 1 32158886 91705396HEALTH SERVICES OF NORTH LOUISIANA Coughran Jimmy R. MD 2106A Loop Rd Winnsboro LA 71295 20 08 1 None 1 2 1 32158886 91705396WINNSBORO MEDICAL CLINIC Allen Linda 3326 Front St. Suite B Winnsboro LA 71295 78 08 1 None 1 2 2 32156690 91715300WINNSBORO MEDICAL CLINIC Hensley Rhonda 3326 Front St. Suite B Winnsboro LA 71295 78 08 1 None 1 2 2 32156690 91715300WINNSBORO MEDICAL CLINIC Nichols Edward Clay 3326 Front St. Suite B Winnsboro LA 71295 78 08 1 None 1 2 2 32156690 91715300WINNSBORO MEDICAL CLINIC Reed Charles E. MD 3326 Front St. Suite B Winnsboro LA 71295 20 08 1 none 1 2 1 32156690 91715300WINNSBORO MEDICAL CLINIC Rollins Jeremy 3326 Front St. Suite B Winnsboro LA 71295 20 08 1 None 1 2 1 32156690 91715300RICHARDSON MEDICAL CENTER Sanfiel Francisco J. P.O. Box 1300 Winnsboro LA 71295 20 02 1 none 1 2 2 32102611 91764539RICHARDSON MEDICAL CENTER Reed Charles E. MD P.O. Box 1350 Winnsboro LA 71295 20 08 1 None 1 2 1 32247181 91710691THE PHYSICIAN'S ALLIANCE CORP (TPAC) Agarwal Harishwar 1337 Centre Court Alexandria LA 71301 20 2K 1 none 1 2 2 31280740 92478157THE PHYSICIAN'S ALLIANCE CORP (TPAC) Buckalew, III Zack 1337 Centre Court Alexandria LA 71301 20 41 1 >=18 1 2 2 31280740 92478157THE PHYSICIAN'S ALLIANCE CORP (TPAC) From Kendall 1337 Centre Court Alexandria LA 71301 20 2K 1 none 1 2 2 31280740 92478157THE PHYSICIAN'S ALLIANCE CORP (TPAC) Garcia Ernesto 1337 Centre Court Alexandria LA 71301 20 41 1 >=18 1 2 2 31280740 92478157THE PHYSICIAN'S ALLIANCE CORP (TPAC) Garcia Roberto 1337 Centre Court Alexandria LA 71301 20 41 1 >=18 1 2 2 31280740 92478157


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Age Restricti

onPCP Link

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Postal Code

THE PHYSICIAN'S ALLIANCE CORP (TPAC) Garcia-Caro Miguel 1337 Centre Court Alexandria LA 71301 20 2M 1 none 1 2 2 31280740 92478157THE PHYSICIAN'S ALLIANCE CORP (TPAC) Garcia-Ramirez Jose 1337 Centre Court Alexandria LA 71301 20 41 1 >=18 1 2 2 31280740 92478157THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morrison Robert 1337 Centre Court Alexandria LA 71301 20 41 1 >=18 1 2 2 31280740 92478157THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wilson Mark 1337 Centre Court Alexandria LA 71301 20 2K 1 none 1 2 2 31280740 92478157LINCARE INC 1360 North MacArthur Dr Alexandria LA 71301 40 54 1 none 1 2 1 31284988 92474872SNELLS LIMB & BRACE COMPANY 1404 Jackson St Alexandria LA 71301 40 53 1 none 1 2 2 31306344 92452932AGGRESSIVE HEALTH SOLUTIONS 1405 Metro Drive Bldg J-1 Alexandria LA 71301 40 54 1 none 1 2 2 31276642 92479089THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bergman Geoffrey 1406 Peterman Drive Alexandria LA 71301 32 48 1 none 1 2 2 31275549 92479912SOUTHERN PEDIATRIC CLINIC Chinagozi Sonji 1416 Metro Drive Alexandria LA 71301 20 37 1 none 1 2 1 31276189 92478919ABANA ORTHOTICS & PROSTHETICS Lutfallah Cesar 1419 Peterman Drive Alexandria LA 71301 40 53 1 none 1 2 2 31275432 92479253MID LA ANESTHESIA CONSULTANT* Barton Eric CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Bayonne Harold MD 1444 Peterman Drive Alexandria LA 71301 20 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Belaire Dwane CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Brister Kevin CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Clay Dennis CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Daigel Dustin CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Doolittle Laurie CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Doolittle Mike CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Garia Rolando CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Hammond Natalie CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Johnson Carrie CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Johnson R. Steven CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Jones Blake CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Leday Patrick CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Legar Sandy CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Lemaire Mark MD 1444 Peterman Drive Alexandria LA 71301 20 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Letsinger Darrin MD 1444 Peterman Drive Alexandria LA 71301 20 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Parker Jarred CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Patton Joseph MD 1444 Peterman Drive Alexandria LA 71301 20 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Peterman Taten H MD 1444 Peterman Drive Alexandria LA 71301 20 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Procell Lindsay CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Rapp Jeffrey MD 1444 Peterman Drive Alexandria LA 71301 20 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Robichauk Francis X MD 1444 Peterman Drive Alexandria LA 71301 20 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Robichaux Francis MD 1444 Peterman Drive Alexandria LA 71301 20 05 1 none 1 2 2 31274731 92478397MID LA ANESTHESIA CONSULTANT* Shine Johanna CRNA 1444 Peterman Drive Alexandria LA 71301 91 05 1 none 1 2 2 31274731 92478397AXIS MEDICAL AND FITNESS EQUIPMENT 1616 Evarist Street Alexandria LA 71301 40 54 1 none 1 2 2 31278811 92475296AKRIDGE JEANIE D ST Akridge Jeanie D. 2009 MacArthur Drive Alexandria LA 71301 39 29 1 none 1 2 2 31277474 92470688THE PHYSICIAN'S ALLIANCE CORP (TPAC) Saad Bashar 201 4th St Suite 3d Alexandria LA 71301 20 2E 1 none 1 2 2 31315219 92450489RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Ardoin Greg MD 201 4th Street Suite 1D Alexandria LA 71301 20 29 1 none 1 1 2 31315219 92450489BROUSSARD PHYSICAL THERAPY CLINIC, INC. Broussard James Keith PT 201 4th Street Suite 5B Alexandria LA 71301 35 65 1 none 1 2 2 31315219 92450489RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Deason Caylon NP 201 4th Street Suite 1D Alexandria LA 71301 78 79 1 >=18 1 1 2 31315219 92450489RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Lindsay Philip MD 201 4th Street Suite 5B Alexandria LA 71301 20 02 1 none 1 1 2 31315219 92450489RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Rath Siddhartha MD 201 4th Street Suite 5B Alexandria LA 71301 20 02 1 none 1 1 2 31315219 92450489RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Timmer Jeremy MD 201 4th Street Suite 5B Alexandria LA 71301 20 02 1 none 1 1 2 31315219 92450489RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Mandelbaum Mark MD 201 Fourth St. Suite 1A Alexandria LA 71301 20 13 1 none 1 1 2 31315219 92450489RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Solon Agnes MD 201 Fourth St. Suite 1A Alexandria LA 71301 20 2M 1 none 1 1 2 31315219 92450489THE PHYSICIAN'S ALLIANCE CORP (TPAC) Warshaw Lesley 2108 Texas Ave Suite 3061 Alexandria LA 71301 20 04 1 none 1 2 1 31283600 92459700THE PHYSICIAN'S ALLIANCE CORP (TPAC) Badeaux, III Joseph 2108 Texas Ave, Ste 3061 Alexandria LA 71301 20 04 1 none 1 2 1 31283600 92459700C. H. Wilkinson Physican Network Broussard Marjorie MD 2108 Texas Avenue Suite 3080 Alexandria LA 71301 20 08 1 None 1 2 2 31283600 92459700C. H. Wilkinson Physican Network Carter Katherine NP 2108 Texas Avenue Suite 3080 Alexandria LA 71301 78 08 1 none 1 2 2 31283600 92459700


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

C. H. Wilkinson Physican Network Milder Peter MD 2108 Texas Avenue Suite 3080 Alexandria LA 71301 20 08 1 None 1 2 2 31283600 92459700C. H. Wilkinson Physican Network Thomas Margo MD 2108 Texas Avenue Suite 3080 Alexandria LA 71301 20 08 1 None 1 2 2 31283600 92459700THE DELTA PATHOLOGY GROUP LLC 211 Fourth St Alexandria LA 71301 20 22 1 none 1 2 1 31315204 92450470OMEGA DIAGNOSTICS, LLC 211 Fourth St Alexandria LA 71301 20 30 1 none 1 2 1 31315204 92450470RAPIDES REGIONAL MEDICAL CENTER 211 Fourth Street Alexandria LA 71301 60 86 1 none 1 1 1 31315204 92450470TONI C HARVEY OD LLC Harvey Toni C. 2148 North Mall Drive Alexandria LA 71301 28 88 1 none 1 2 2 31276970 92457405BRUCE L. CRAIG Craig Bruce L. MD, FAAFP 2913 Lee St Alexandria LA 71301 20 08 1 none 1 2 1 31285767 92450531THE PHYSICIAN'S ALLIANCE CORP (TPAC) Mccabe John 301 4th St Box 30150 Alexandria LA 71301 20 24 1 none 1 2 2 31314369 92449446ZEIBO MOHAMMAD A MD Zeibo Mohammad A. 301 Fourth St. Alexandria LA 71301 20 13 1 none 1 2 1 31314369 92449446RAPIDES PHYSICAL THERAPY Forester Samuel MPT 3016 Jackson Street Alexandria LA 71301 35 65 1 none 1 2 2 31291265 92469497HAISSAM N BOUZ, MD Bouz Haissam N. MD 3311 Prescott Rd Ste 314 Alexandria LA 71301 20 16 1 >=16 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Eubanks Beth S. 3311 Prescott Rd Suite 112 Alexandria LA 71301 78 79 1 >=18 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Freedman, Jr. Robert 3311 Prescott Rd Ste 112 Alexandria LA 71301 20 06 1 none 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hanley Henry 3311 Prescott Rd Suite 112 Alexandria LA 71301 20 06 1 none 1 2 1 31284244 92462895C. H. Wilkinson Physican Network Ingalls Amanda L. MD 3311 Prescott Rd Suite 211 Alexandria LA 71301 20 16 1 >=16 1 2 1 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Stowe Deann 3311 Prescott Rd Suite 112 Alexandria LA 71301 78 08 1 >=18 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Younes Alaa 3311 Prescott Rd Suite 112 Alexandria LA 71301 20 06 1 none 1 2 1 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Parrish James 3311 Prescott Rd, Ste 201 Alexandria LA 71301 20 02 1 none 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Watkins Wayne 3311 Prescott Rd, Ste 201 Alexandria LA 71301 20 02 1 none 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Taylor Robert 3311 Prescott Rd, Ste 203 Alexandria LA 71301 35 65 1 none 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Younes Maan 3311 Prescott Rd, Ste 318 Alexandria LA 71301 20 29 1 none 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Aguilar Darryl 3311 Prescott Rd, Suite 201 Alexandria LA 71301 20 02 1 none 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bledsoe Samuel 3311 Prescott Rd, Suite 201 Alexandria LA 71301 20 02 1 none 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Conerly James 3311 Prescott Rd, Suite 201 Alexandria LA 71301 20 02 1 none 1 2 2 31284244 92462895LOUISIANA CARDIOVASCULAR & THORACIC INSTITUTE DeWitt Robert Chance 3311 Prescott Rd. Suite 202 Alexandria LA 71301 20 33 1 none 1 2 1 31284244 92462895LOUISIANA CARDIOVASCULAR & THORACIC INSTITUTE Jones Gary P. 3311 Prescott Rd. Suite 202 Alexandria LA 71301 20 33 1 none 1 2 2 31284244 92462895LOUISIANA CARDIOVASCULAR & THORACIC INSTITUTE Manzer Craig W. 3311 Prescott Rd. Suite 202 Alexandria LA 71301 78 79 1 >=18 1 2 2 31284244 92462895C. H. Wilkinson Physican Network Letsinger Kelly MD 3311 Prescott Road Alexandria LA 71301 20 41 1 >=18 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Morrison Maury 3311 Prescott Road Suite 411 Alexandria LA 71301 20 10 1 none 1 2 2 31284244 92462895C. H. Wilkinson Physican Network Tauseef M. Asif MD 3311 Prescott Road Alexandria LA 71301 20 37 1 <=18 1 2 2 31284244 92462895C. H. Wilkinson Physican Network Young Martin MD 3311 Prescott Road Alexandria LA 71301 20 2E 1 none 1 2 2 31284244 92462895THE PHYSICIAN'S ALLIANCE CORP (TPAC) Hidalgo Gonzalo 3311 Prescott Road, Ste 26 Alexandria LA 71301 20 13 1 none 1 2 2 31284244 92462895AUDIBEL HEARING HEALTHCARE 3327 B Jackson St. Alexandria LA 71301 34 64 1 none 1 2 2 31285760 92454986THE PHYSICIAN'S ALLIANCE CORP (TPAC) Al-halawani Hafez 3330 Masonic Dr Suite 2040 Alexandria LA 71301 20 2H 1 none 1 2 2 31282827 92460747THE PHYSICIAN'S ALLIANCE CORP (TPAC) Gill Kasey MSN 3330 Masonic Dr Suite 2040 Alexandria LA 71301 78 79 1 >=18 1 2 2 31282827 92460747THE PHYSICIAN'S ALLIANCE CORP (TPAC) Saccaro Steven 3330 Masonic Dr Suite 2040 Alexandria LA 71301 20 2H 1 none 1 2 2 31282827 92460747THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ule Ulla 3330 Masonic Dr Suite 2040 Alexandria LA 71301 20 2H 1 none 1 2 2 31282827 92460747THE PHYSICIAN'S ALLIANCE CORP (TPAC) Walcott Gillian 3330 Masonic Dr Suite 2040 Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747CHRISTUS HEALTH CENTRAL LA 3330 Masonic Drive Alexandria LA 71301 60 86 1 none 1 2 1 31282827 92460747C. H. Wilkinson Physican Network Doman Florence MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Donelon Shawn MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Fontil Valy MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Foret Gerald MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Ghetia Ditina MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Liu HongYang MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Mai Minh MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Mavani Gaurang MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Mensah-Armoo Elsie MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Olatinwo Omotayo MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=55 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Quebedeaux Andy MD 3330 Masonic Drive Alexandria LA 71301 20 08 1 None 1 2 2 31282827 92460747


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

C. H. Wilkinson Physican Network Sams John MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Slatkin Alexandre MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Smith George MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Tekle Tesfai MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Verghese Cherian MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747C. H. Wilkinson Physican Network Verma Devinder MD 3330 Masonic Drive Alexandria LA 71301 20 41 1 >=18 1 2 2 31282827 92460747THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vincent, III Vincent 3335 Prescott Road Alexandria LA 71301 20 16 1 >=16 1 2 2 31283766 92463328THE PHYSICIAN'S ALLIANCE CORP (TPAC) Shbeeb Mohammad 3349 Masonic Drive Alexandria LA 71301 20 2M 1 none 1 2 2 31282092 92460922THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bacilla, Jr. Philip 3351 Masonic Dr Alexandria LA 71301 20 20 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Brunet Michael 3351 Masonic Dr Alexandria LA 71301 20 20 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Crenshaw William 3351 Masonic Dr Alexandria LA 71301 20 20 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Drury Benjamin 3351 Masonic Dr Alexandria LA 71301 20 20 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Eubanks Julie 3351 Masonic Dr Alexandria LA 71301 78 08 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Leddy, III Michael 3351 Masonic Dr Alexandria LA 71301 20 20 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Perdue Louis 3351 Masonic Dr Alexandria LA 71301 20 20 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Rich Christopher 3351 Masonic Dr Alexandria LA 71301 20 20 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sunderhaus Paul 3351 Masonic Dr Alexandria LA 71301 32 48 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Turregano Frances FNP 3351 Masonic Dr Alexandria LA 71301 78 08 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dodson Mark 3351 Masonic Drive Alexandria LA 71301 20 20 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Saucier Maria 3351 Masonic Drive Alexandria LA 71301 32 48 1 none 1 2 2 31282047 92460962THE PHYSICIAN'S ALLIANCE CORP (TPAC) Texada Charles 3351 Masonic Drive Alexandria LA 71301 20 20 1 none 1 2 2 31282047 92460962RAPIDES REGIONAL PHYSICIAN GROUP Primary Care Joiner Charles MD 3516 North Blvd Suite B Alexandria LA 71301 20 08 1 none 1 1 2 31277980 92457212RAPIDES REGIONAL PHYSICIAN GROUP Primary Care Perez Alejandro MD 3517 North Blvd Suite B Alexandria LA 71301 20 08 1 none 1 1 2 31278015 92456893THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dozier Timothy 3704 North Blvd Suite 2 Alexandria LA 71301 20 30 1 none 1 2 1 31275713 92456349THE PHYSICIAN'S ALLIANCE CORP (TPAC) Larson Paul 3704 North Blvd Suite 2 Alexandria LA 71301 20 30 1 none 1 2 1 31275713 92456349THE PHYSICIAN'S ALLIANCE CORP (TPAC) Long William 3704 North Blvd Suite 2 Alexandria LA 71301 20 30 1 none 1 2 1 31275713 92456349THE PHYSICIAN'S ALLIANCE CORP (TPAC) Monsour Alfred 3704 North Blvd Suite 2 Alexandria LA 71301 20 30 1 none 1 2 2 31275713 92456349THE PHYSICIAN'S ALLIANCE CORP (TPAC) Sarchasinh Rachadip 3704 North Blvd Suite 2 Alexandria LA 71301 20 30 1 none 1 2 1 31275713 92456349THE PHYSICIAN'S ALLIANCE CORP (TPAC) Culbertson Howard 3704 North Blvd, Ste C Alexandria LA 71301 20 13 1 none 1 2 2 31275713 92456349THE PHYSICIAN'S ALLIANCE CORP (TPAC) Dowd Gregory 3704 North Blvd, Ste C Alexandria LA 71301 20 13 1 none 1 2 2 31275713 92456349THE PHYSICIAN'S ALLIANCE CORP (TPAC) Downs Stephen 3704 North Blvd, Ste C Alexandria LA 71301 20 08 1 None 1 2 2 31275713 92456349THE PHYSICIAN'S ALLIANCE CORP (TPAC) Drerup Michael 3704 North Blvd, Ste C Alexandria LA 71301 20 14 1 none 1 2 2 31275713 92456349THE PHYSICIAN'S ALLIANCE CORP (TPAC) Vaughn Troy 3704 North Blvd, Ste C Alexandria LA 71301 20 14 1 none 1 2 2 31275713 92456349THE PHYSICIAN'S ALLIANCE CORP (TPAC) Baker Sharifa 3802 Prescott Road Alexandria LA 71301 20 08 1 None 1 2 2 31277708 92468543THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bevels Gregory 3802 Prescott Road Alexandria LA 71301 20 08 1 None 1 2 2 31277708 92468543WOMEN'S CLINIC OF ALEXANDER Bowers, Jr. Gordon S. MD 501 Medical Center Dr Ste 300 Alexandria LA 71301 20 16 1 >=16 1 2 1 31313626 92450288WOMEN'S CLINIC OF ALEXANDER Hooter, II Ward C. MD 501 Medical Center Dr Ste 300 Alexandria LA 71301 20 16 1 >=16 1 2 1 31313626 92450288WOMEN'S CLINIC OF ALEXANDER Rabie Khaled F. MD 501 Medical Center Dr Ste 300 Alexandria LA 71301 20 16 1 >=16 1 2 1 31313626 92450288ALEXANDRIA CARDIOLOGY CLINIC Chaudhry Ilyas 501 Medical Center Dr., Ste. 250 Alexandria LA 71301 20 06 1 >=18 1 2 1 31313626 92450288ALEXANDRIA CARDIOLOGY CLINIC Jaffroni Naseem 501 Medical Center Dr., Ste. 250 Alexandria LA 71301 20 06 1 >=18 1 2 2 31313626 92450288ALEXANDRIA CARDIOLOGY CLINIC Kaimol P. K. 501 Medical Center Dr., Ste. 250 Alexandria LA 71301 20 06 1 >=18 1 2 2 31313626 92450288ALEXANDRIA CARDIOLOGY CLINIC Leyser Larry 501 Medical Center Dr., Ste. 250 Alexandria LA 71301 20 06 1 >=18 1 2 2 31313626 92450288MANSOOR PEDIATRICS 501 Medical Center Drive Suite 3A Alexandria LA 71301 20 37 1 <=18 1 2 1 31313626 92450288MANSOOR PEDIATRICS Delcambre Becy NP 501 Medical Center Drive Suite 3A Alexandria LA 71301 78 79 1 <=18 1 2 2 31313626 92450288MANSOOR PEDIATRICS Grant Toni MD 501 Medical Center Drive Suite 3A Alexandria LA 71301 20 37 1 <=18 1 2 2 31313626 92450288MANSOOR PEDIATRICS Mansoor Shahid MD 501 Medical Center Drive Suite 3A Alexandria LA 71301 20 37 1 <=18 1 2 1 31313626 92450288MANSOOR PEDIATRICS Mitchell Marcia MD 501 Medical Center Drive Suite 3A Alexandria LA 71301 20 37 1 <=18 1 2 1 31313626 92450288MANSOOR PEDIATRICS Monk Patricia Hope NP 501 Medical Center Drive Suite 3A Alexandria LA 71301 78 79 1 <=18 1 2 2 31313626 92450288MANSOOR PEDIATRICS Nagarai Suma MD 501 Medical Center Drive Suite 3A Alexandria LA 71301 20 37 1 <=18 1 2 2 31313626 92450288MANSOOR PEDIATRICS Weir Robin NP 501 Medical Center Drive Suite 3A Alexandria LA 71301 78 79 1 <=18 1 2 1 31313626 92450288


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RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Dean Roshanda MD 501 Medical Ctr Dr Suite 4A Alexandria LA 71301 20 16 1 >=16 1 1 2 31313626 92450288RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Middleton Jamie MD 501 Medical Ctr Dr Suite 4A Alexandria LA 71301 20 16 1 >=16 1 1 2 31313626 92450288RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Spence David MD 501 Medical Ctr Dr Suite 4A Alexandria LA 71301 20 16 1 >=16 1 1 2 31313626 92450288BERACAH HEALTHCARE SOLUTIONS 5302 Jacquella Drive Alexandria LA 71301 40 54 1 none 1 2 1 31261804 92454731THE PHYSICIAN'S ALLIANCE CORP (TPAC) Norwood Charles 821 Elliott Street Alexandria LA 71301 20 08 1 None 1 2 1 31310949 92450848THE PHYSICIAN'S ALLIANCE CORP (TPAC) Slaughter Clois 821 Elliott Street Alexandria LA 71301 20 08 1 none 1 2 2 31310949 92450848RAPIDES PRIMARY HEALTH CARE CENTER 1217 Willow Glen River Rd Alexandria LA 71302 72 9L 1 none 1 2 1 31286662 92426095RAPIDES PRIMARY HEALTH CARE CENTER Draper April D. 1217 Willow Glen River Road Alexandria LA 71302 78 08 1 none 1 2 2 31286662 92426095RAPIDES PRIMARY HEALTH CARE CENTER Dugan Eric S. MD 1217 Willow Glen River Road Alexandria LA 71302 20 08 1 none 1 2 1 31286662 92426095RAPIDES PRIMARY HEALTH CARE CENTER Freeman Joseph A. MD 1217 Willow Glen River Road Alexandria LA 71302 20 08 1 none 1 2 1 31286662 92426095RAPIDES PRIMARY HEALTH CARE CENTER Pilatova Renata MD 1217 Willow Glen River Road Alexandria LA 71302 20 37 1 <=18 1 2 1 31286662 92426095AKRIDGE JEANIE D ST Akridge Jeanie D. 31 Reynolds Road Alexandria LA 71302 39 29 1 none 1 2 2 31156224 92296592HANGER PROSTHETICS AND ORTHOTICS 104 B Constitution Blvd Alexadria LA 71303 40 53 1 none 1 2 1 31313812 92496722HANGER PROSTHETICS AND ORTHOTICS 104 B Constitution Boulevard Alexandria LA 71303 40 53 1 none 1 2 1 31272763 92499183Hanger Prosthetics & Orthotics Inc. 104B Constitution Boulevard Alexandria LA 71303 40 53 1 none 1 1 2 31298610 92485675RAPIDES REGIONAL PHYSICIAN GROUP Specialty Care Go Anita MD 1268 South Hampton Drive Alexandria LA 71303 20 1D 1 none 1 1 2 31283799 92478657MEDICAL TECHNOLOGY OF LA INC 1301 Wimbledon Alexandria LA 71303 40 54 1 none 1 2 2 31279251 92482748SYNERGY HOME CARE-CENTRAL REGION, INC 137 Yorktown Dr Alexandria LA 71303 44 75 1 none 1 2 2 31303500 92480400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Griffin Amy B. 145 Yorktown Alexandria LA 71303 20 08 1 None 1 2 2 31303500 92480400THE PHYSICIAN'S ALLIANCE CORP (TPAC) Griffin Christopher 145 Yorktown Alexandria LA 71303 20 08 1 None 1 2 2 31303500 92480400LINCARE INC 1630 NORTH MACARTHUR DR ALEXANDRIA LA 71303 40 54 1 none 1 1 2 31318706 92472829THE PHYSICIAN'S ALLIANCE CORP (TPAC) Close Benjamin 201 Pecan Park Ave Alexandria LA 71303 20 03 1 none 1 2 1 31294596 92490348Apria Healthcare, Inc. 21A and B Heyman Lane Alexandria LA 71303 40 54 1 none 1 1 2 31292639 92479615FAIRCLOTH CHIROPRACTIC CLINIC Faircloth Kelly B. 3620 Bayou Rapides Rd Alexandria LA 71303 30 35 1 none 1 2 2 31303957 92483905RISINGER WILLIAM C OD Risinger, Jr. William C. OD 3908 Parliament Dr. Alexandria LA 71303 28 88 1 none 1 2 2 31283337 92478958THE PHYSICIAN'S ALLIANCE CORP (TPAC) Miller Wilvan 3912 Parliament Dr Alexandria LA 71303 35 65 1 none 1 2 2 31283320 92478969THE PHYSICIAN'S ALLIANCE CORP (TPAC) Warner Brian 3912 Parliament Dr Alexandria LA 71303 29 71 1 none 1 2 2 31283320 92478969PREMIER PEDIATRICS Clark John L. 3916 Jackson Street Ext. Alexandria LA 71303 20 37 1 <=18 1 2 2 31283014 92477463THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pate James 4124 Jackson Street Ext Alexandria LA 71303 20 04 1 none 1 2 2 31279997 92479319THE PHYSICIAN'S ALLIANCE CORP (TPAC) Boisvert Robert 5501 Coliseum Blvd Alexandria LA 71303 30 35 1 none 1 2 2 31295172 92506111VISION SOURCE ALEXANDRIA Shaw Lacy OD 5615B Jackson St. Alexandria LA 71303 28 88 1 none 1 2 1 31268539 92486250LA IMAGING SERVICES LLC 5731 Jackson St Ste C Alexandria LA 71303 20 30 1 none 1 2 2 31267189 92487053SOIGNE HEALTH CARE MGMT INC 5731 Jackson St. Ext. Ste C Alexandria LA 71303 40 54 1 none 1 2 2 31267189 92487053LEBLANC Eye Center LeBlanc Cornel H. OD, FOAA 5917 Jackson St. Alexandria LA 71303 28 88 1 none 1 2 1 31264761 92488691BUNKIE GENERAL HOSPITAL 109 N. Lexington Avenue Bunkie LA 71322 79 94 1 none 1 2 2 30954381 92186591LAPOINT SR PAUL B. OD LaPoint Sr Paul B. MD 1121 N. W. Main Street Suite 5 Bunkie LA 71322 28 88 1 none 1 2 1 30961615 92195754BUNKIE GENERAL HOSPITAL 427 Evergreen Street Bunkie LA 71322 60 86 1 none 1 2 2 30953636 92177970THE PHYSICIAN'S ALLIANCE CORP (TPAC) Singletary John 510 Cottonwood Street Bunkie LA 71322 35 65 1 none 1 2 2 30954201 92176086THE PHYSICIAN'S ALLIANCE CORP (TPAC) Singletary Pamela 510 Cottonwood Street Bunkie LA 71322 35 65 1 none 1 2 2 30954201 92176086BUNKIE GENERAL HOSPITAL 510 S. Cottonwood St. Bunkie LA 71322 79 94 1 none 1 2 2 30954201 92176086ALEX JOSEPH MD Joseph Alex MD 510 S. Cottonwood St. Burkie LA 71322 20 16 1 >=16 1 2 1 30954201 92176086RICHARDSON MEDICAL CENTER Lee Sarah 100 Lincoln Ave Ferriday LA 71334 20 08 1 None 1 2 2 31649957 91555955RIVERLAND MEDICAL CENTER Barlow Donnah NP 104 Louisiana Ave Ferriday LA 71334 78 08 1 None 1 2 2 31629633 91551697RIVERLAND MEDICAL CENTER Lauer Michael MD 104 Louisiana Ave Ferriday LA 71334 20 08 1 None 1 2 2 31629633 91551697HUEY MOAK Moak Huey H. MD 112 Serio Blvd Ferriday LA 71334 20 08 1 None 1 2 1 31648505 91553811RIVERLAND MEDICAL CENTER 1700 EE Wallace Blvd N Ferriday LA 71334 60 86 1 none 1 2 2 31666709 91543987CATAHOULA PARISH HOSP DIST #2 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 72 9L 1 none 1 2 2 31627011 91551934CATAHOULA PARISH HOSP DIST #2 Arnold Hugh G. FNP 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 78 08 1 None 1 2 2 31627011 91551934CATAHOULA PARISH HOSP DIST #2 Gray Cynthia M. FNP 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 78 08 1 None 1 2 1 31627011 91551934CATAHOULA PARISH HOSP DIST #2 Howard Susan A. FNP 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 78 08 1 None 1 2 1 31627011 91551934


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CATAHOULA PARISH HOSP DIST #2 Kemmerly Kenneth W. MD 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 20 08 1 None 1 2 2 31627011 91551934CATAHOULA PARISH HOSP DIST #2 Knapp Charla W. FNP 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 78 08 1 >=18 1 2 2 31627011 91551934CATAHOULA PARISH HOSP DIST #2 Oliver Ashley B. 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 78 08 1 None 1 2 2 31627011 91551934CATAHOULA PARISH HOSP DIST #2 Porter Mary A. FNP 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 78 79 1 >=18 1 2 1 31627011 91551934CATAHOULA PARISH HOSP DIST #2 Schneider Mark A. MD 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 20 08 1 None 1 2 2 31627011 91551934CATAHOULA PARISH HOSP DIST #2 Smith Roger 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 20 37 1 <=18 1 2 1 31627011 91551934CATAHOULA PARISH HOSP DIST #2 Trunzler Basil G. MD 1810 E. E. Wallace Elvd Suite 6 Ferriday LA 71334 20 34 1 none 1 2 2 31627011 91551934CARRIE BONOMO Bonomo Carrie MD 1810 EE Wallace Blvd. #5 Ferriday LA 71334 20 37 1 <=18 1 2 1 31672746 91541257MAURICE GREMILLION Gremillion Maurice J. MD 200 Serio Blvd. Ferriday LA 71334 20 08 1 None 1 2 2 31649558 91556148RIVERLAND MEDICAL CENTER Gibson Herman MD 204 Serio Blvd Ferriday LA 71334 20 08 1 None 1 2 2 31649572 91556180RIVERLAND MEDICAL CENTER Sozen Selcuk MD 204 Serio Blvd Ferriday LA 71334 20 24 1 none 1 2 2 31649572 91556180GREGG RONNIE CMD Gregg Ronnie C. MD, FACS 206 Serio Blvd. Ferriday LA 71334 20 02 1 none 1 2 1 31649578 91556195WHITAKER DICK S OD Miliken Bridget A. 210 Serio Blvd Ferriday LA 71334 28 88 1 none 1 2 1 31649592 91556226WHITAKER DICK S OD Whitaker Dick S. 210 Serio Blvd Ferriday LA 71334 28 88 1 none 1 2 1 31649592 91556226RICHARDSON MEDICAL CENTER Smith Raymond 241 Aimee Dr Ferriday LA 71334 91 05 1 none 1 2 1 31703602 91462386RICHARDSON MEDICAL CENTER Guillot Mary 241 Aimee Drive Ferriday LA 71334 91 05 1 none 1 2 2 31703602 91462386RICHARDSON MEDICAL CENTER Soileau Robbie J. c/o Riverside Hospital Surgery Dept Ferriday LA 71334 91 05 1 none 1 2 1 31646209 91569873LASALLE GENERAL HOSP HBP Ahmed Tariq 180 Ninth Street Jena LA 71342 20 37 1 <=18 1 2 1 31681100 92110200LASALLE GENERAL HOSP HBP Crenshaw Louis 180 Ninth Street Jena LA 71342 78 08 1 None 1 2 2 31681100 92110200LASALLE GENERAL HOSP HBP Erickson Mathew 180 Ninth Street Jena LA 71342 20 08 1 None 1 2 1 31681100 92110200LASALLE GENERAL HOSP HBP Gallaspy John W. 180 Ninth Street Jena LA 71342 20 16 1 >=16 1 2 2 31681100 92110200LASALLE GENERAL HOSP HBP Godley Clifford 180 Ninth Street Jena LA 71342 20 1T 1 none 1 2 2 31681100 92110200LASALLE GENERAL HOSP HBP Kendrick Robert 180 Ninth Street Jena LA 71342 20 08 1 None 1 2 2 31681100 92110200LASALLE GENERAL HOSP HBP Kendrick-Hodges Allison 180 Ninth Street Jena LA 71342 78 08 1 None 1 2 2 31681100 92110200LASALLE GENERAL HOSP HBP 187 Ninth Street Jena LA 71342 60 86 1 none 1 2 2 31681100 92110200LASALLE GENERAL HOSP HBP Erickson Mathew 187 Ninth Street Jena LA 71342 20 08 1 None 1 2 1 31681100 92110200LASALLE GENERAL HOSP HBP Godley Clifford 187 Ninth Street Jena LA 71342 20 1T 1 none 1 2 2 31681100 92110200LASALLE GENERAL HOSP HBP Rohr Gabriela 187 Ninth Street Jena LA 71342 20 1T 1 none 1 2 1 31681100 92110200LASALLE GENERAL HOSP HBP 212 Ninth Street Jena LA 71342 44 75 1 none 1 2 2 31528371 92195466CLAUSS CHARLES D DC Clauss Charles D. DC 2804 North First St. Jena LA 71342 30 35 1 none 1 2 2 31687812 92132735LASALLE GENERAL HOSP HBP 2801 Fourth Street Jonesville LA 71343 79 94 1 none 1 2 1 31617804 91847096LASALLE GENERAL HOSP HBP Ahmed Tariq 2801 Fourth Street Jonesville LA 71343 20 37 1 <=18 1 2 1 31617804 91847096LASALLE GENERAL HOSP HBP Erickson Mathew 2801 Fourth Street Jonesville LA 71343 20 08 1 None 1 2 1 31617804 91847096LASALLE GENERAL HOSP HBP Flaherty Patrice 2801 Fourth Street Jonesville LA 71343 20 08 1 None 1 2 2 31617804 91847096LASALLE GENERAL HOSP HBP Stallings Jerry 2801 Fourth Street Jonesville LA 71343 78 08 1 None 1 2 2 31617804 91847096WILLIAM C. CONEY, MD Coney William C. 904 First Street Jonesville LA 71343 20 08 1 None 1 2 2 31630469 91820671THE PHYSICIAN'S ALLIANCE CORP (TPAC) Foti Christopher 1610 Water St Lecompte LA 71346 20 08 1 None 1 2 1 31086413 92404381RAPIDES REGIONAL PHYSICIAN GROUP Primary Care Churchman Nichole MD 1610 Water Street Lecompte LA 71346 20 08 1 none 1 1 2 31086413 92404381RAPIDES REGIONAL PHYSICIAN GROUP Primary Care Slaughter Darien MD 1610 Water Street Lecompte LA 71346 20 08 1 none 1 1 2 31086413 92404381SYNERGY HOME CARE-CENTRAL REGION, INC 114 N. Main Street Marksville LA 71351 44 75 1 none 1 2 2 31126279 92067066PREDRAG GAGIC Gagic Predrag M. MD 313 Center St. Marksville LA 71351 20 02 1 none 1 2 2 31125428 92073994AVOYELLES OPEN MRI LLC 319 Center Street Marksville LA 71351 20 30 1 none 1 2 2 31125422 92073970MANSOOR PEDIATRICS Grant Toni MD 337 Moreau Street Suite C Marksville LA 71351 20 37 1 <=18 1 2 2 31119270 92068798MANSOOR PEDIATRICS Monk Patricia Hope NP 337 Moreau Street Suite C Marksville LA 71351 78 79 1 <=18 1 2 2 31119270 92068798MANSOOR PEDIATRICS Nagarai Suma MD 337 Moreau Street Suite C Marksville LA 71351 20 37 1 <=18 1 2 2 31119270 92068798ELIAS MOUNAYAR Mounayar Elias Raymond 338 Moreau St Marksville LA 71351 20 41 1 >=18 1 2 1 31119384 92069091AUDIBEL HEARING HEALTHCARE 430 N. Washington St Marksville LA 71351 34 64 1 none 1 2 2 31126876 92065159SANCHEZ, S. FRANK, O.D. Sanchez S. Frank OD 470 Acton Road Marksville LA 71351 28 88 1 none 1 2 2 31117970 92068586THE THERAPY CENTER OF AVOYELLES Ebersohn George PT 5435 Hwy 1 Marksville LA 71351 35 65 1 none 1 2 2 31137700 92089900C. H. Wilkinson Physican Network Brouillette Beau MD 5541 Highway 1 Marksville LA 71351 20 08 1 None 1 2 1 31133900 92083500


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C. H. Wilkinson Physican Network Coutee Clara NP 5541 Highway 1 Marksville LA 71351 78 08 1 none 1 2 1 31133900 92083500C. H. Wilkinson Physican Network Ducote Misty NP 5541 Highway 1 Marksville LA 71351 78 08 1 none 1 2 2 31133900 92083500C. H. Wilkinson Physican Network Garcia Fernando MD 5541 Highway 1 Marksville LA 71351 20 41 1 >=18 1 2 2 31133900 92083500C. H. Wilkinson Physican Network Kalifey Edmond MD 5541 Highway 1 Marksville LA 71351 20 08 1 None 1 2 2 31133900 92083500ALEX JOSEPH MD Joseph Alex MD 597 Tunica Marksville LA 71351 20 16 1 >=16 1 2 1 31127765 92077761HEALTH SERVICES OF NORTH LOUISIANA Colvin Thomas L. MD 104 Verona Newellton LA 71357 20 08 1 None 1 2 1 32071733 91245707THE PHYSICIAN'S ALLIANCE CORP (TPAC) Nance Judith 1135 Expressway Dr Suite 200a Pineville LA 71360 20 08 1 None 1 2 2 31320696 92425381THE PHYSICIAN'S ALLIANCE CORP (TPAC) Wallace, Jr. James E. 1135 Expressway Dr Ste 200a Pineville LA 71360 20 08 1 None 1 2 2 31320696 92425381MANSOOR PEDIATRICS 192 Stilley Rd Pineville LA 71360 79 94 1 <=18 1 2 1 31322287 92380395MANSOOR PEDIATRICS Grant Toni MD 192 Stilley Road Pineville LA 71360 20 37 1 <=18 1 2 2 31322287 92380395MANSOOR PEDIATRICS Monk Patricia Hope NP 192 Stilley Road Pineville LA 71360 78 79 1 <=18 1 2 2 31322287 92380395MANSOOR PEDIATRICS Weir Robin NP 192 Stilley Road Pineville LA 71360 78 79 1 <=18 1 2 1 31322287 92380395HAYES JENNIFER C ST Branch Andrea 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311HAYES JENNIFER C ST Cain Charlotte 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311HAYES JENNIFER C ST DeJean Jean 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311HAYES JENNIFER C ST Evans Denise 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311HAYES JENNIFER C ST Hayes Jennifer 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311HAYES JENNIFER C ST Henderson Chandra 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311HAYES JENNIFER C ST Horne Megan 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311HAYES JENNIFER C ST Kear Judy 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311HAYES JENNIFER C ST Richard Gynda 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311HAYES JENNIFER C ST Townsend Carol 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311HAYES JENNIFER C ST Williams-Joseph Dedra 208 Sweetwater Rim Pineville LA 71360 29 71 1 none 1 2 2 31346554 92392311NIRANJAN S. PATEL, MD Patel Niranjan S. MD 3113 E Highway 28 East Pineville LA 71360 20 37 1 <=18 1 2 1 31333043 92398465ANTOON ROBERT E Antoon Robert E. OD 329 Edgewood Dr. Pineville LA 71360 28 88 1 none 1 2 2 31337753 92399508VISION SOURCE ALEXANDRIA Shaw Lacy OD 5504 Shreveport Hwy Pineville LA 71360 28 88 1 none 1 2 1 31395195 92439074TENSAS COMMUNITY HEALTH CENTER 402 Levee Street St. Joseph LA 71366 72 9L 1 <=18 1 2 2 31914303 91233716CATAHOULA PARISH HOSP DIST #2 307 Chisum Street Sicily Island LA 71368 72 9L 1 none 1 2 2 31846997 91658081CATAHOULA PARISH HOSP DIST #2 Arnold Hugh G. FNP 307 Chisum Street Sicily Island LA 71368 78 08 1 None 1 2 2 31846997 91658081CATAHOULA PARISH HOSP DIST #2 Gray Cynthia M. FNP 307 Chisum Street Sicily Island LA 71368 78 08 1 None 1 2 1 31846997 91658081CATAHOULA PARISH HOSP DIST #2 Howard Susan A. FNP 307 Chisum Street Sicily Island LA 71368 78 08 1 None 1 2 1 31846997 91658081CATAHOULA PARISH HOSP DIST #2 Kemmerly Kenneth W. MD 307 Chisum Street Sicily Island LA 71368 20 08 1 None 1 2 2 31846997 91658081CATAHOULA PARISH HOSP DIST #2 Knapp Charla W. FNP 307 Chisum Street Sicily Island LA 71368 78 08 1 >=18 1 2 2 31846997 91658081CATAHOULA PARISH HOSP DIST #2 Oliver Ashley B. 307 Chisum Street Sicily Island LA 71368 78 08 1 None 1 2 2 31846997 91658081CATAHOULA PARISH HOSP DIST #2 Porter Mary A. FNP 307 Chisum Street Sicily Island LA 71368 78 79 1 >=18 1 2 1 31846997 91658081CATAHOULA PARISH HOSP DIST #2 Schneider Mark A. MD 307 Chisum Street Sicily Island LA 71368 20 08 1 None 1 2 2 31846997 91658081CATAHOULA PARISH HOSP DIST #2 Smith Roger 307 Chisum Street Sicily Island LA 71368 20 37 1 <=18 1 2 1 31846997 91658081CATAHOULA PARISH HOSP DIST #2 Trunzler Basil G. MD 307 Chisum Street Sicily Island LA 71368 20 34 1 none 1 2 2 31846997 91658081STEPHEN KUPLESKY Kuplesky Steve MD 314 Christine Lane Simmesport LA 71369 20 08 1 none 1 2 1 30998872 91845323THE PHYSICIAN'S ALLIANCE CORP (TPAC) Chaudhry Riaz 11809 Hwy 84 W Jena LA 71371 20 41 1 >=18 1 2 1 31721551 92294745AUDIBEL HEARING HEALTHCARE 107 Carter St. Extension Vidalia LA 71373 34 64 1 none 1 2 2 31566000 91425300PEDIATRIC & ADOLESCENT CLINIC 1806 Carter Street Vidalia LA 71373 79 94 1 None 1 2 1 31572484 91449427PEDIATRIC & ADOLESCENT CLINIC Ballard Deanna D. 1806 Carter Street Vidalia LA 71373 78 08 1 None 1 2 1 31572484 91449427PEDIATRIC & ADOLESCENT CLINIC Knapp Charla W. 1806 Carter Street Vidalia LA 71373 78 08 1 None 1 2 2 31572484 91449427PEDIATRIC & ADOLESCENT CLINIC Mascagni Jennifer R. 1806 Carter Street Vidalia LA 71373 78 08 1 None 1 2 2 31572484 91449427PEDIATRIC & ADOLESCENT CLINIC Timm David A. 1806 Carter Street Vidalia LA 71373 20 37 1 <=18 1 2 1 31572484 91449427CARING HANDS MEDICAL STORE 1810 Carter Street Vidalia LA 71373 40 54 1 none 1 2 2 31572506 91449562MAGNOLIA MEDICAL LLC 400 Carter Street Vidalia LA 71373 40 54 1 none 1 2 2 31566834 91428619RICHARDSON MEDICAL CENTER Sayer Janet D. Riverpark Ambulatory Surgery Ctr Vidalia LA 71373 91 05 1 none 1 2 1 31578865 91499056CATAHOULA PARISH HOSP DIST #2 126 Watson Street Wisner LA 71378 72 9L 1 none 1 2 2 31986395 91655854


LOI Contract STP*

Geocoding



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New Patient

Age Restricti

onPCP Link

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2nd Line of Address

Postal Code

CATAHOULA PARISH HOSP DIST #2 Arnold Hugh G. FNP 126 Watson Street Wisner LA 71378 78 08 1 None 1 2 2 31986395 91655854CATAHOULA PARISH HOSP DIST #2 Gray Cynthia M. FNP 126 Watson Street Wisner LA 71378 78 08 1 None 1 2 1 31986395 91655854CATAHOULA PARISH HOSP DIST #2 Howard Susan A. FNP 126 Watson Street Wisner LA 71378 78 08 1 None 1 2 1 31986395 91655854CATAHOULA PARISH HOSP DIST #2 Kemmerly Kenneth W. MD 126 Watson Street Wisner LA 71378 20 08 1 None 1 2 2 31986395 91655854CATAHOULA PARISH HOSP DIST #2 Knapp Charla W. FNP 126 Watson Street Wisner LA 71378 78 08 1 >=18 1 2 2 31986395 91655854CATAHOULA PARISH HOSP DIST #2 Oliver Ashley B. 126 Watson Street Wisner LA 71378 78 08 1 None 1 2 2 31986395 91655854CATAHOULA PARISH HOSP DIST #2 Porter Mary A. FNP 126 Watson Street Wisner LA 71378 78 79 1 >=18 1 2 1 31986395 91655854CATAHOULA PARISH HOSP DIST #2 Schneider Mark A. MD 126 Watson Street Wisner LA 71378 20 08 1 None 1 2 2 31986395 91655854CATAHOULA PARISH HOSP DIST #2 Smith Roger 126 Watson Street Wisner LA 71378 20 37 1 <=18 1 2 1 31986395 91655854CATAHOULA PARISH HOSP DIST #2 Trunzler Basil G. MD 126 Watson Street Wisner LA 71378 20 34 1 none 1 2 2 31986395 91655854CENLA RURAL HEALTH CARE Piland Jay L. MD 340 Webb Smith Rd Colfax LA 71417 20 41 1 >=18 1 2 1 31524305 92689860CENLA RURAL HEALTH CARE Bordelon Lori D. 340 Webb Smith Rd. Colfax LA 71417 20 41 1 none 1 2 1 31524305 92689860CENLA RURAL HEALTH CARE 340 Webb Smith Road Colfax LA 71417 79 94 1 none 1 2 2 31524305 92689860HEALTH SERVICES OF NORTH LOUISIANA Connell Robert E. MD 484 Collins Road, Suite A Columbia LA 71418 20 08 1 None 1 2 2 32076222 92095059HEALTH SERVICES OF NORTH LOUISIANA Cummings Russell O. MD 484 Collins Road, Suite A Columbia LA 71418 20 02 1 none 1 2 1 32076222 92095059HEALTH SERVICES OF NORTH LOUISIANA Ellerbe William Michael MD 484 Collins Road, Suite A Columbia LA 71418 20 08 1 None 1 2 1 32076222 92095059PANKAJRAI SHROFF Shroff Pankajrai S. 7937 US Hwy 165 Columbia LA 71418 20 41 1 >=18 1 2 2 32037980 92120397HEALTH SERVICES OF NORTH LOUISIANA 7939 Highway 165 Columbia LA 71418 60 86 1 none 1 2 2 32037947 92120426THE PHYSICIAN'S ALLIANCE CORP (TPAC) Ghanta Guru 1015 W Fertitta Blvd Leesville LA 71446 20 02 1 none 1 2 2 31137141 93269284THE PHYSICIAN'S ALLIANCE CORP (TPAC) Pande Hemant 1015 W Fertitta Blvd Leesville LA 71446 20 10 1 none 1 2 1 31137141 93269284GHANTA GURU P MD Ghanta Guru P. MD 1015 West Fertitta Blvd. Leesville LA 71446 20 02 1 none 1 2 2 31137141 93269284BYRD REGIONAL HOSPITAL 1020 Fertitta Blvd Leesville LA 71446 60 86 1 none 1 2 2 31137416 93269290BYRD MEDICAL CLINIC Ghetia Ditina K. 1020 Fertitta Blvd. Leesville LA 71446 20 08 1 None 1 2 2 31137416 93269290BYRD MEDICAL CLINIC Saidan Mohammad M. 1020 Fertitta Blvd. Leesville LA 71446 20 08 1 None 1 2 2 31137416 93269290NAILA KHATEEB Khateeb Naila Imran 1022 Port Arthur Terrace Leesville LA 71446 20 37 1 <=18 1 2 1 31141066 93272444COWAN CHERRI T OD Cowan Clifton M. OD 1100 N. 5th St Leesville LA 71446 28 88 1 none 1 2 2 31152768 93263872COWAN CHERRI T OD Cowan Cherri T. OD 1100 N. 5th St. Leesville LA 71446 28 88 1 none 1 2 1 31152768 93263872LEESVILLE HEART CENTER Meadaa Reymond 1106 Port Arthur Terrace Leesville LA 71446 20 06 1 none 1 2 2 31139570 93273233THE PHYSICIAN'S ALLIANCE CORP (TPAC) Meadaa Reymond 1106a Port Arthur Terrace Leesville LA 71446 20 06 1 none 1 2 2 31139570 93273233FOOT CLINIC OF WEST LOUISIANA 1108 Port Arthur Terrace Leesville LA 71446 32 48 1 none 1 2 2 31139524 93273209FOOT CLINIC OF WEST LOUISIANA Cortz Jayson G. MD 1108 Port Arthur Terrace Leesville LA 71446 20 48 1 none 1 2 2 31139524 93273209FOOT CLINIC OF WEST LOUISIANA Harvey Jim B. MD 1108 Port Arthur Terrace Leesville LA 71446 20 48 1 none 1 2 1 31139524 93273209VERNON MEDICAL CARE CENTER 111 W. Harriet St Leesville LA 71446 40 54 1 none 1 2 2 31140337 93263941MINERVA RAMIREZ, M.D. APMC Ramirez Minerva 1110 Port Arthur Terrace Leesville LA 71446 20 16 1 >=16 1 2 1 31139451 93273179BYRD MEDICAL CLINIC Yubaraja Bhattarai 1112 Port Arthur Terrace Leesville LA 71446 20 08 1 None 1 2 2 31139402 93273165BYRD MEDICAL CLINIC Fraser Francis A. 1201 Fertitta Blvd. Leesville LA 71446 20 02 1 none 1 2 2 31137140 93269361BYRD MEDICAL CLINIC Moss Melissa K. 1201 Fertitta Blvd. Leesville LA 71446 20 08 1 None 1 2 2 31137140 93269361OUTPATIENT MEDICAL CENTER INC Matta Anil S. MD 1603 B. Boone St Leesville LA 71446 20 08 1 none 1 2 1 31122771 93273961ALAMMAR MEDICAL CLINIC, PLLC Alammar Hussein A. 1750 South 5th Street Leesville LA 71446 20 41 1 >=18 1 2 1 31126058 93267738QUICKCARE MD Gaddis Todd 500 S. 6th St Leesville LA 71446 20 08 1 None 1 2 2 31140307 93265075THE PHYSICIAN'S ALLIANCE CORP (TPAC) Granger Shawn 506 S 6th Street Leesville LA 71446 20 20 1 none 1 2 2 31140259 93265072BYRD MEDICAL CLINIC Cohen Benjamin 506 S. 6th Street Leesville LA 71446 32 48 1 none 1 2 2 31140259 93265072BYRD MEDICAL CLINIC Gozaine Teofilo C. 506 S. 6th Street Leesville LA 71446 20 04 1 none 1 2 1 31140259 93265072BYRD MEDICAL CLINIC Ghorab Khaled M. 700 S. 6th Street Leesville LA 71446 20 04 1 none 1 2 2 31138129 93265129BYRD MEDICAL CLINIC Park H. John 700 S. 6th Street Leesville LA 71446 20 20 1 none 1 2 2 31138129 93265129DOCTORS HOSPITAL AT DEER CREEK 815 South 10th Street Leesville LA 71446 60 86 1 none 1 2 2 31136976 93269388MIRZA BEG Beg Mirza Ashhab 935 Verone Terrace Leesville LA 71446 20 37 1 <=18 1 2 1 31140239 93271220MERIDIAN MEDICAL SUPPLY LLC 1005 Fisher Rd Many LA 71449 40 54 1 none 1 2 2 31557118 93471960SABINE MEDICAL CENTER 1015 Obrie Street Many LA 71449 79 94 1 none 1 2 2 31629369 93470334HUSAM SUKEREK MD - (RHC) 210 Highland Drive Many LA 71449 79 94 1 none 1 2 2 31559819 93470758


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

HUSAM SUKEREK MD - (RHC) Sukerek Husam H. MD 210 Highland Drive Many LA 71449 20 37 1 <=18 1 2 1 31559819 93470758BYRD MEDICAL CLINIC Cohen Benjamin 220B Highland Drive Many LA 71449 32 48 1 none 1 2 2 31559988 93470867PRECISION RADIOLOGY MANAGEMENT 240 Highland Dr Many LA 71449 20 30 1 none 1 2 2 31560326 93471086SABINE HOSPITALIST PHYSICIAN Pearson Charles R. MD 240 Highland Dr Many LA 71449 20 41 1 >=18 1 2 2 31560326 93471086NORTH LA SURGERY CENTER 240 Highland Drive Many LA 71449 20 02 1 none 1 2 2 31560326 93471086SABINE MEDICAL CENTER 240 Highland Drive Many LA 71449 60 86 1 none 1 2 2 31560326 93471086BYRD MEDICAL CLINIC Gozaine Teofilo C. 240 Highland Drive Many LA 71449 20 04 1 none 1 2 1 31560326 93471086NORTH LA SURGERY CENTER Sasaki Larry S. MD 240 Highland Drive Many LA 71449 20 02 1 none 1 2 2 31560326 93471086BYRD MEDICAL CLINIC Ghorab Khaled M. 255 Highland Drive Many LA 71449 20 04 1 none 1 2 2 31560712 93470968BYRD MEDICAL CLINIC Moss Melissa K. 255 Highland Drive Many LA 71449 20 08 1 None 1 2 2 31560712 93470968BYRD MEDICAL CLINIC Park H. John 255 Highland Drive Many LA 71449 20 20 1 none 1 2 2 31560712 93470968BROUSSARD PHYSICAL THERAPY CLINIC, INC. Broussard James Keith PT 295 Highland Dr. Many LA 71449 35 65 1 none 1 2 2 31561387 93471405THE PHYSICIAN'S ALLIANCE CORP (TPAC) Broussard Keith 295 Highland Drive Many LA 71449 35 65 1 none 1 2 2 31561387 93471405THE PHYSICIAN'S ALLIANCE CORP (TPAC) Patton Melissa 295 Highland Drive Many LA 71449 37 74 1 none 1 2 2 31561387 93471405SABINE MEDICAL CENTER 395 S. Capitol Street Many LA 71449 79 94 1 none 1 2 2 31567010 93484081Ashley Ridge Medicine, LLC Lau Chi Tai Peter MD Sabine Medical Center 240 Highland Drive Many LA 71449 20 08 1 None 1 2 1 31560326 93471086MERIDIAN MEDICAL SUPPLY LLC 1029 Keyser Ave Natchitoches LA 71457 40 54 1 none 1 2 2 31752707 93062943HIGHLAND CLINIC Kampert Kurt W. MD 1029 Keyser Avenue Natchitoches LA 71457 20 2M 1 none 1 2 2 31752707 93062943CORNERSTONE PEDIATRICS Carpenter Carlisa A. CPNP 1055 Parkway Drive Ste A Natchitoches LA 71457 93 37 1 <=18 1 2 2 31750552 93062493CORNERSTONE PEDIATRICS Rodriguez Brett C. 1055 Parkway Drive Ste A Natchitoches LA 71457 20 37 1 <=18 1 2 1 31750552 93062493CORNERSTONE PEDIATRICS Rodriguez Christa P. 1055 Parkway Drive Ste A Natchitoches LA 71457 20 37 1 <=18 1 2 1 31750552 93062493CORNERSTONE PEDIATRICS Thibodaux, Jr. James P. MD 1055 Parkway Drive Ste A Natchitoches LA 71457 20 37 1 <=18 1 2 1 31750552 93062493SYNERGY HOME CARE-NORTHWESTERN REGION, INC 129 Industrial Ave Natchitoches LA 71457 44 75 1 none 1 2 2 31803700 93091800THE PHYSICIAN'S ALLIANCE CORP (TPAC) Guidroz Richard 132 East 5th Street Natchitoches LA 71457 35 65 1 none 1 2 2 31749769 93079870THE PHYSICIAN'S ALLIANCE CORP (TPAC) Jones Jerry 132 East 5th Street Natchitoches LA 71457 35 65 1 none 1 2 2 31749769 93079870THE PHYSICIAN'S ALLIANCE CORP (TPAC) Miller Mary 132 East 5th Street Natchitoches LA 71457 35 65 1 none 1 2 2 31749769 93079870THE PHYSICIAN'S ALLIANCE CORP (TPAC) Parker Jason 132 East 5th Street Natchitoches LA 71457 35 65 1 none 1 2 2 31749769 93079870OUTPATIENT MEDICAL CENTER INC Adeleye Ovayoza I. MD 1640 Breazeale Springs St Natchitoches LA 71457 20 37 1 <=18 1 2 1 31780516 93102117OUTPATIENT MEDICAL CENTER INC Matta Anil S. MD 1640 Breazeale Springs St Natchitoches LA 71457 20 08 1 none 1 2 1 31780516 93102117OUTPATIENT MEDICAL CENTER INC Roberts Lynda MD 1640 Breazeale Springs St Natchitoches LA 71457 20 08 1 >=18 1 2 1 31780516 93102117LINCARE INC 200 SOUTH DRIVE SUITE 2 NATCHITOCHES LA 71457 40 54 1 none 1 1 2 31747370 93082424NORTHWESTERN LOUISIANA CANCER Menache Lawrence P. MD 211 Medical Drive Natchitoches LA 71457 20 2J 1 none 1 2 1 31753568 93075709HIGHLAND CLINIC Reddy Shantan G. MD 211 Medical Drive Natchitoches LA 71457 20 2H 1 none 1 2 2 31753568 93075709HIGHLAND CLINIC Walker Donna A. MD 211 Medical Drive Rural Area Natchitoches LA 71457 20 2H 1 none 1 2 1 31753568 93075709SAMARITAN HOME MEDICAL EQUIPMENT 321 South Drive Natchitoches LA 71457 40 54 1 none 1 2 2 31744727 93081962SHALOM CLINIC FOR CHILDREN APMC Oshikanlu Olabisi 405 Bienville St Natchitoches LA 71457 20 37 1 <=18 1 2 1 31751923 93080064SHALOM CLINIC FOR CHILDREN APMC Adeleye Olusegun 405 Bienville St. Natchitoches LA 71457 20 37 1 <=18 1 2 1 31751923 93080064AUDIBEL HEARING HEALTHCARE 4080 University Parkway Natchitoches LA 71457 34 64 1 none 1 2 2 31745500 93091200REGIONAL CARDIOLOGY CLINIC Britton Dennis 501 Keyser Ave Natchitoches LA 71457 20 06 1 none 1 2 2 31753688 93079062REGIONAL CARDIOLOGY CLINIC Ingram Christopher Lee MD 501 Keyser Ave Natchitoches LA 71457 20 06 1 >=16 1 2 2 31753688 93079062NATCHITOCHES FAMILY EYE CARE Keator Randall D. OD 946 Keyser Ave Natchitoches LA 71457 28 88 1 none 1 2 1 31752521 93065110NATCHITOCHES FAMILY EYE CARE Wardell Pete OD 946 Keyser Ave Natchitoches LA 71457 28 88 1 none 1 2 1 31752521 93065110ALEX JOSEPH MD Joseph Alex MD 107 Hospital Dr Oakdale LA 71463 20 16 1 >=16 1 2 1 30817124 92645059QUALITY MEDICAL CARE AND SERVICES, LLC 107 Hospital Dr. Oakdale LA 71463 40 54 1 none 1 2 1 30817124 92645059PROFESSIONAL MEDICAL SUPPLIES 111-A East 6th Ave. Oakdale LA 71463 40 54 1 none 1 2 2 30815922 92663620M. R. GHANTA, M.D. Ghanta Madhusudana R. MD 115 Hospital Dr Oakdale LA 71463 20 37 1 none 1 2 1 30817069 92644959OAKDALE School Based Health Center Crawford Sylvia Sonnier ENP 124 South 13th Street Building 2 Oakdale LA 71463 78 08 1 None 1 2 2 30815573 92657899ZETA HOME HEALTH CARE 203 N. 16th Street Oakdale LA 71463 40 54 1 none 1 2 2 30818467 92651310RAPIDES REGIONAL PHYSICIAN GROUP Primary Care Bharwani Sunil MD 400 E Sixth Avenue Oakdale LA 71463 20 08 1 none 1 1 2 30815531 92659270RAPIDES REGIONAL PHYSICIAN GROUP Primary Care Jerez Catherine MD 400 E Sixth Avenue Oakdale LA 71463 20 08 1 none 1 1 2 30815531 92659270


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

GERDES JR GERALD OD Gerdes, Jr. Gerald OD 414 E. 7th Avenue Oakdale LA 71463 28 88 1 none 1 2 1 30817436 92659107BRUCE L. CRAIG Craig Bruce L. MD, FAAFP 3819 Patterson St Pollock LA 71467 20 08 1 none 1 2 1 31523565 92400110WILLIAMS JERRY W Williams Jerry W. OD 1605 West Court St. Winnfield LA 71483 28 88 1 none 1 2 1 31931789 92653221JAMES R WALKER OD Walker James R. OD 207 S. St. John Street Winnfield LA 71483 28 88 1 none 1 2 1 31849989 92518312L. R. COLLIER Collier L. R. 301 B West Boundary Winnfield LA 71483 20 02 1 none 1 2 1 31922212 92624591DIXIE MEDICAL EQUIPMENT 430 W. South Avenue Winnfield LA 71483 40 54 1 none 1 2 2 31923939 92642769WINN COMMUNITY HEALTH CENTER 431 West Lafayette St. Winnfield LA 71483 72 9L 1 none 1 2 2 31925100 92642834WINN COMMUNITY HEALTH CENTER Shelton Mark MD 431 West lafayette St. Winnfield LA 71483 20 08 1 none 1 2 2 31925100 92642834WINN COMMUNITY HEALTH CENTER Howard April 431 West Layayette St. Winnfield LA 71483 78 08 1 none 1 2 2 31924650 92653759RUSTON CLINIC COMPANY LLC Blair Major E. MD 601 W. Lafayette St. Winnfield LA 71483 20 20 1 none 1 2 2 31925116 92646260RUSTON CLINIC COMPANY LLC Lacayo Leonel MD 601 W. Lafayette St. Winnfield LA 71483 20 10 1 none 1 2 2 31925116 92646260RUSTON CLINIC COMPANY LLC Langiulli Michael MD 601 W. Lafayette St. Winnfield LA 71483 20 06 1 none 1 2 2 31925116 92646260RUSTON CLINIC COMPANY LLC Zuckerman Victor MD 601 W. Lafayette Street Winnfield LA 71483 20 37 1 <=18 1 2 2 31925116 92646260SHALOM CLINIC FOR CHILDREN (RHC) Adeleye Olusegun 609 West Court St., Ste. B Winnfield LA 71483 20 37 1 <=18 1 2 1 31925976 92645397SHALOM CLINIC FOR CHILDREN (RHC) Oshikanlu Olabisi 609 West Court St., Ste. B Winnfield LA 71483 20 37 1 <=18 1 2 1 31925976 92645397SHALOM CLINIC FOR CHILDREN (RHC) 609 West Court Street Suite B Winnfield LA 71483 79 94 1 none 1 2 1 31925976 92645397SHALOM CLINIC FOR CHILDREN (RHC) Morris Detries 609 West Court Street, Ste B Winnfield LA 71483 78 08 1 none 1 2 2 31925976 92645397THE PHYSICIAN'S ALLIANCE CORP (TPAC) Bostick-Field Kimberly 9372 Hwy 165 Woodworth LA 71485 78 08 1 None 1 2 1 31141706 92498008WOODWORTH FAMILY MED INC 9372 Hwy 165 South Woodworth LA 71485 79 94 1 none 1 2 1 31141706 92498008WOODWORTH FAMILY MED INC Guillot David J. 9372 Hwy 165 South Woodworth LA 71485 20 08 1 None 1 2 1 31141706 92498008Ashley Ridge Medicine, LLC Lau Chi Tai Peter MD Sabine Rural Health Clinic 1015 Obrie Street Zwolle LA 71486 20 08 1 None 1 2 1 31647658 93643037THE DELTA PATHOLOGY GROUP LLC 611 St. Landry Lafayette LA 71506 20 22 1 none 1 2 1UNITED MEDICAL 7300 DOLLARWAY ROAD SUITES 115 & 116 WHITE HALL AR 71602 40 54 1 none 1 1 2 34262206 92082946LABCORP 1606 W 42ND AVE PINE BLUFF AR 71603 20 30 1 none 1 1 2 34186368 92017618LINCARE INC 3139 WEST 28TH PINE BLUFF AR 71603 40 54 1 none 1 1 2 34201980 92034664UNITED MEDICAL 520 WEST GAINES STREET MONTICELLO AR 71655 40 54 1 none 1 1 2 33629313 91793863LINCARE INC 403 NORTH NEWTON EL DORADO AR 71730 40 54 1 none 1 1 2 33214892 92671661LINCARE INC 499 COLLIN RAYE DRIVE DE QUEEN AR 71832 40 54 1 none 1 1 2 34045694 94342381UNITED MEDICAL 4501 NORTH HIGHWAY 7 SUITES 14 & 15 HOT SPRINGS VILL AR 71909 40 54 1 none 1 1 2 34652772 93056702UNITED MEDICAL 1340 HIGDON FERRY ROAD SUITE A HOT SPRINGS AR 71913 40 54 1 none 1 1 2 34469718 93067605UNITED MEDICAL 2503 PINE ST SUITE 5 ARKADELPHIA AR 71923 40 54 1 none 1 1 2 34122983 93079455UNITED MEDICAL 1101 MUSEUM ROAD SUITE 3 CONWAY AR 72032 40 54 1 none 1 1 2 35093978 92419014LINCARE INC 619 NORTH FIRST STREET UNIT B JACKSONVILLE AR 72076 40 54 1 none 1 1 2 34872873 92109339UNITED MEDICAL 1300 MCLAIN STREET NEWPORT AR 72112 40 54 1 none 1 1 2 35607952 91265052UNITED MEDICAL 8735 SHELTIE DRIVE SUITE D NORTH LITTLE ROC AR 72113 40 54 1 none 1 1 2 34812438 92358736LABCORP 4623 E MCCAIN BLVD NORTH LITTLE ROC AR 72117 20 30 1 none 1 1 2 34789199 92212238UNITED MEDICAL 2704 EAST RACE STREET SEARCY AR 72143 40 54 1 none 1 1 2 35250387 91705037UNITED MEDICAL 223 SOUTH MAIN STUTTGART AR 72160 40 54 1 none 1 1 2 34500907 91552385LINCARE INC 10600 COLONEL GLENN ROAD SUITE 300 LITTLE ROCK AR 72204 40 54 1 none 1 1 2 34712644 92394173PEDIATRIC SPECIALISTS 1601 WESTPARK DR SUITE 1 LITTLE ROCK AR 72204 40 54 1 none 1 1 2 34738148 92350972UNITED MEDICAL 1910 JOHN BARROW ROAD SUITE B LITTLE ROCK AR 72204 40 54 1 none 1 1 2 34736437 92372612LABCORP 500 S UNIVERSITY AVE STE 704 DOCTORS BLDG. LITTLE ROCK AR 72205 20 30 1 none 1 1 2 34747905 92341511Quest Diagnostics 500 S University Ste 218 Little Rock AR 72205 20 30 1 none 1 1 2 34747905 92341511UNITED MEDICAL 11523 KANIS ROAD SUITE C LITTLE ROCK AR 72211 40 54 1 none 1 1 2 34743230 92401745LINCARE INC 309 NORTH 6TH STREET #5 & 6 WEST MEMPHIS AR 72301 40 54 1 none 1 1 2 35149699 90176760UNITED MEDICAL 1945 N FALLS BLVD SUITE 1 WYNNE AR 72396 40 54 1 none 1 1 2 35248756 90781525PEDIATRIC SPECIALISTS 1500 E WASHINGTON AVE SUITE C JONESBORO AR 72401 40 54 1 none 1 1 2 35837779 90686757

2520 ALEXANDER DRIVE SUITE C JONESBORO AR 72401 40 54 1 none 1 1 2 35820237 90734601UNITED MEDICAL 2609 SW SQ CIRCLE JONESBORO AR 72401 40 54 1 none 1 1 2 35829450 90734648Quest Diagnostics 901 Osler Drive Ste D Jonesboro AR 72401 20 30 1 none 1 1 2 35834372 90693459


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

UNITED MEDICAL 1975 HARRISON STREET BATESVILLE AR 72501 40 54 1 none 1 1 2 35769401 91631739LINCARE INC 1321 N MAIN HARRISON AR 72601 40 54 1 none 1 1 2 36243679 93114541Quest Diagnostics 1310 Highway 62 West Ste 10 Mountain Home AR 72653 20 30 1 none 1 1 2 36326838 92389975UNITED MEDICAL 707 NORTH CARDINAL SUITE 1 MOUNTAIN HOME AR 72653 40 54 1 none 1 1 2 36348252 92371153

2901 E ZION RD SUITE 11 FAYETTEVILLE AR 72703 40 54 1 none 1 1 2 36129315 94119796

LABCORP 509 E MILLSAP RD STE 103 FAYETTEVILLE AR 72703 20 30 1 none 1 1 2 36114046 94150427LINCARE INC 68 WEST SUNBRIDGE FAYETTEVILLE AR 72703 40 54 1 none 1 1 2 36098123 94157940Quest Diagnostics Fayetteville AR 72703 20 30 1 none 1 1 2 36123263 94133730PEDIATRIC SPECIALISTS 2927 N POINT CIRCLE SUITE 1 FAYETTEVILLE AR 72704 40 54 1 none 1 1 2 36105038 94177683Quest Diagnostics 1200 SE 28th St. Bentonville AR 72712 20 30 1 none 1 1 2 36342454 94194899UNITED MEDICAL 2711 S.E. I STREET SUITES 5 & 7 BENTONVILLE AR 72712 40 54 1 none 1 1 2 36342903 94199659LINCARE INC 644 WEST LANCASHIRE BLVD BELLA VISTA AR 72715 40 54 1 none 1 1 2 36454769 94291232UNITED MEDICAL 5204 S THOMPSON SUITE F SPRINGDALE AR 72764 40 54 1 none 1 1 2 36135519 94145328UNITED MEDICAL 1509 EAST MAIN STRET SUITE 9 RUSSELLVILLE AR 72801 40 54 1 none 1 1 2 35266565 93129519LINCARE INC 305 NORTH ELMIRA RUSSELLVILLE AR 72802 40 54 1 none 1 1 2 35281387 93102768LABCORP 1823 DODSON AVE FORT SMITH AR 72901 20 30 1 none 1 1 2 35372506 94413508LINCARE INC 523 LEXINGTON AVENUE FORT SMITH AR 72901 40 54 1 none 1 1 2 35378925 94417462Quest Diagnostics 4300 Rogers Ave Ste. 47 Ft Smith AR 72903 20 30 1 none 1 1 2 35368844 94384904UNITED MEDICAL 5811 SOUTH 28TH STREET FORT SMITH AR 72908 40 54 1 none 1 1 2 35326461 94404350PAR MEDICAL INC 12 B. Sussex St. Kenner LA 73062 40 54 1 none 1 2 1 35095025 98750174180 MEDICAL INC 5324 West Reno Suite A Oklahoma City OK 73127 40 54 1 none 1 2 1 35464074 97611459LABCORP 1735 KELLER SPRINGS RD STE 202 CARROLLTON TX 75006 20 30 1 none 1 1 2 32972617 96893488LINCARE INC 2554 TARPLEY ROAD SUITE 104 CARROLLTON TX 75006 40 54 1 none 1 1 2 32984890 96851453Quest Diagnostics 2008 E Hebron Pkwy Ste 110 Carrollton TX 75007 20 30 1 none 1 1 2 33024516 96878931Quest Diagnostics 1101 Raintree Cir Suite 100 Allen TX 75013 20 30 1 none 1 1 2 33115249 96675656LABCORP 1111 RAINTREE CIR STE 250 ALLEN TX 75013 20 30 1 none 1 1 2 33113375 96675431Quest Diagnostics 546 E Sandy Lake Rd Ste 120 Coppell TX 75019 20 30 1 none 1 1 2 32969699 96977542LINCARE INC 1631 WEST MORTON STREET DENISON TX 75020 40 54 1 none 1 1 2 33760426 96558844Quest Diagnostics 1201 Arista Dr Suite 107 Rockwall TX 75032 20 30 1 none 1 1 2 32898800 96456200LABCORP 3880 PARKWOOD BLVD BLDG 3 FRISCO TX 75034 20 30 1 none 1 1 2 33112082 96815609Quest Diagnostics 5575 Warren Pkwy Ste 303 Frisco TX 75034 20 30 1 none 1 1 2 33106600 96840208LINCARE INC 3884 SOUTH SHILOH ROAD SUITE 120 GARLAND TX 75041 40 54 1 none 1 1 2 32870395 96665296

LABCORP 2231 PEGGY LN STE B GARLAND TX 75042 20 30 1 none 1 1 2 32916314 96658890Quest Diagnostics 777 Walter Reed Blvd Ste 102 Garland TX 75042 20 30 1 none 1 1 2 32919894 96663724Hanger Prosthetics & Orthotics West Inc. 510 West 1-30 Suite 213 Garland TX 75043 40 53 1 none 1 1 2 32857007 96608156LABCORP 2701 OSLER DR,STE 2 GRAND PRAIRIE TX 75051 20 30 1 none 1 1 2 32731862 97046271Quest Diagnostics 5224 S State Highway 360 Suite 225 Grand Prairie TX 75052 20 30 1 none 1 1 2 32647813 97063935Quest Diagnostics 6053 Main Street, Suite 110 The Colony TX 75056 20 30 1 none 1 1 2 33091832 96892979LABCORP 560 W MAIN ST STE 202 LEWISVILLE TX 75057 20 30 1 none 1 1 2 33046177 97005960LABCORP 1302 LANE ST STE 800 IRVING TX 75061 20 30 1 none 1 1 2 32833579 96962280LINCARE INC 2912 N MACARTHUR BLVD SUITE 106 IRVING TX 75062 40 54 1 none 1 1 2 32846810 96958862Quest Diagnostics 3501 N Macarthur Blvd Ste 310 Bldg Iii Irving TX 75062 20 30 1 none 1 1 2 32852344 96959282LABCORP 7501 LAS COLINAS BLVD STE 100 IRVING TX 75063 20 30 1 none 1 1 2 32909909 96955008Apria Healthcare, Inc. 8300 Esters Blvd Ste 920 Irving TX 75063 40 54 1 none 1 1 2 32920824 97007768Quest Diagnostics 500 N Valley Pkwy Ste 110 Lewisville TX 75067 20 30 1 none 1 1 2 33047608 97020851Quest Diagnostics 4510 Medical Center Dr Ste 310 Mc Kinney TX 75069 20 30 1 none 1 1 2 33161454 96635693LABCORP 1515 HERITAGE PKWY,STE100 HERITAGE MCKINNEY TX 75069 20 30 1 none 1 1 2 33137336 96600737LABCORP 4201 MEDICAL CENTER DR STE 390 MCKINNEY TX 75069 20 30 1 none 1 1 2 33162028 96635603

N.HILLS MEDICAL PARK

Butterfield Professional Bldg1792 E Joyce Ste 5

WALNUT & PEGGY LN


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

LABCORP 4510 MEDICAL CENTER DR STE 212 MCKINNEY TX 75069 20 30 1 none 1 1 2 33161454 96635693LINCARE INC 901 N MCDONALD STREET SUITE 508 MCKINNEY TX 75069 40 54 1 none 1 1 2 33205704 96612032LABCORP 3709 W 15TH ST STE 301 PLANO TX 75075 20 30 1 none 1 1 2 33019518 96763013Hanger Prosthetics & Orthotics West Inc. 3801 W 15th St Suite 155 Plano TX 75075 40 53 1 none 1 1 2 33019519 96763307Quest Diagnostics 3801 W 15th St Ste 100 Building A Plano TX 75075 20 30 1 none 1 1 2 33019519 96763307LABCORP 3804 W 15TH #210 PLANO PROF CTR PLANO TX 75075 20 30 1 none 1 1 2 33019107 96763318LABCORP 2001 N COLLINS BLVD STE 105 RICHARDSON TX 75080 20 30 1 none 1 1 2 32975701 96723808Quest Diagnostics 400 N Coit Rd Ste 1920 Richardson TX 75080 20 30 1 none 1 1 2 32956270 96768639LABCORP 2821 E PRESIDENT GEORGE BUSH HWY STE 302 RICHARDSON TX 75082 20 30 1 none 1 1 2 32985100 96665100LABCORP 9400 LAKEVIEW PKWY STE 119 ROWLETT TX 75088 20 30 1 none 1 1 2 32920313 96510703Quest Diagnostics 9824 Lakeview Pkwy Ste 200 Rowlett TX 75088 20 30 1 none 1 1 2 32921189 96507316Quest Diagnostics 1010 La Salle Dr Sherman TX 75090 20 30 1 none 1 1 2 33670219 96604537Apria Healthcare, Inc. 118 W Pecan St Sherman TX 75090 40 54 1 none 1 1 2 33638364 96610188LABCORP 2001 N LOY LAKE RD STE M SHERMAN TX 75090 20 30 1 none 1 1 2 33658063 96605548Hanger Prosthetics & Orthotics West Inc. 3737 Loy Lake Road Sherman TX 75090 40 53 1 none 1 1 2 33677006 96606757LABCORP 300 N HIGHLAND #340 WILSON N.JONES SHERMAN TX 75092 20 30 1 none 1 1 2 33636011 96623137Quest Diagnostics 3600 Communications Parkway Suite 647 Plano TX 75093 20 30 1 none 1 1 2 33048165 96832768LABCORP 5944 W PARKER RD STE 200 PLANO TX 75093 20 30 1 none 1 1 2 33045086 96825257LINCARE INC 809 N MAIN ST CORSICANA TX 75110 40 54 1 none 1 1 2 32099999 96469389Quest Diagnostics 2727 Bolton Boone Dr Suite 106 Desoto TX 75115 20 30 1 none 1 1 2 32645040 96878608LABCORP 951 YORK DR STE 105 DESOTO TX 75115 20 30 1 none 1 1 2 32645669 96880011LABCORP 874 W HIGHWAY 243 STE 114 KAUFMAN TX 75142 20 30 1 none 1 1 2 32591163 96318559LABCORP 3220 GUS THOMASSON RD STE 226 MESQUITE TX 75150 20 30 1 none 1 1 2 32808662 96633852Quest Diagnostics 3230 I- 30 East Ste 101 Mesquite TX 75150 20 30 1 none 1 1 2 32812763 96647925LABCORP 5308 N GALLOWAY #202 MESQUITE TX 75150 20 30 1 none 1 1 2 32835384 96635354LINCARE INC 310 WATER STREET WAXAHACHIE TX 75165 40 54 1 none 1 1 2 32387157 96848547Quest Diagnostics 1411 N. Beckley Ave Pavilion Iii, Suite 450 Dallas TX 75203 20 30 1 none 1 1 2 32757272 96809105LABCORP 221 W COLORADO BLVD STE 300 DALLAS TX 75208 20 30 1 none 1 1 2 32759433 96825719Quest Diagnostics 221 W Colorado Ste 443 Dallas TX 75208 20 30 1 none 1 1 2 32759433 96825719Quest Diagnostics 1151 N Buckner Blvd Ste 106 Dallas TX 75218 20 30 1 none 1 1 2 32834578 96703655

LABCORP 9323 GARLAND RD STE 106 DALLAS TX 75218 20 30 1 none 1 1 2 32831769 96705192

LABCORP 2909 S HAMPTON RD STE B106 DALLAS TX 75224 20 30 1 none 1 1 2 32715259 96857263LABCORP 3535 N BUCKNER BLVD STE 102 DALLAS TX 75228 20 30 1 none 1 1 2 32803479 96682742

Hanger Prosthetics & Orthotics West Inc. 7777 Forest Lane Dallas TX 75230 40 53 1 none 1 1 2 32909582 96772049

LABCORP 7777 FOREST LN BLDG A STE 105 DALLAS TX 75230 20 30 1 none 1 1 2 32909582 96772049Quest Diagnostics 8160 Walnut Hill Lane, Suite 211a Dallas TX 75231 20 30 1 none 1 1 2 32882596 96764574

LABCORP 8160 WALNUT HILL LN #215 DALLAS TX 75231 20 30 1 none 1 1 2 32882596 96764574

LABCORP 8220 WALNUT HILL LN STE 503 DALLAS TX 75231 20 30 1 none 1 1 2 32883139 96762793Quest Diagnostics 8230 Walnut Hill Ln Bldg Iii Ste 400 Dallas TX 75231 20 30 1 none 1 1 2 32883139 96761583LABCORP 8305 WALNUT HILL #220 WOODHILL DALLAS TX 75231 20 30 1 none 1 1 2 32883543 96762081Quest Diagnostics 8305 Walnut Hill Ln Ste 120 Dallas TX 75231 20 30 1 none 1 1 2 32883543 96762081Quest Diagnostics 9301 N Central Expy Suite 151 Dallas TX 75231 20 30 1 none 1 1 2 32874852 96770767Quest Diagnostics 8 Medical Pkwy Plaza Ii Ste 305 Dallas TX 75234 20 30 1 none 1 1 2 32919248 96878960LABCORP 8877 HARRY HINES BLVD #400 DALLAS TX 75235 20 30 1 none 1 1 2 32838848 96867788

DOCTORS PROF BLDG II

RENAISSANCE HOSPITAL

Ste 406 Bldg C Medical City

MEDICAL CITY HOSPITAL

PRESBYTERIAN MARGOT PEROT

PRESBY BUILDING II SUITE 503


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Quest Diagnostics 3430 W Wheatland Rd Ste 224 Dallas TX 75237 20 30 1 none 1 1 2 32647306 96875968LABCORP 3430 WHEATLAND RD STE 218 CHARLTON POB I DALLAS TX 75237 20 30 1 none 1 1 2 32647306 96875968Quest Diagnostics 11613 N Central Expwy Ste 118 Dallas TX 75243 20 30 1 none 1 1 2 32906625 96769524Quest Diagnostics 3600 Gaston Ave Wadley Tower Ste 1057 Dallas TX 75246 20 30 1 none 1 1 2 32796127 96767051

LABCORP 3600 GASTON AVE #705 DALLAS TX 75246 20 30 1 none 1 1 2 32791202 96779809

LABCORP 3801 GASTON AVE STE 104 DALLAS TX 75246 20 30 1 none 1 1 2 32792115 96779204Quest Diagnostics 3900 Junius St Ste 240 Dallas TX 75246 20 30 1 none 1 1 2 32791014 96777971Hanger Prosthetics & Orthotics West Inc. 3910 Gaston Avenue Suite 150 Dallas TX 75246 40 53 1 none 1 1 2 32792396 96778404RICHARDSON MEDICAL CENTER Grayson Patrick C. 17304 Preston Rd Ste 555 Dallas TX 75252 20 08 1 None 1 2 2 32987072 96802979RICHARDSON MEDICAL CENTER Sweet Selika M. 17304 Preston Rd Ste 555 Dallas LA 75252 20 08 1 None 1 2 2 32987072 96802979RICHARDSON MEDICAL CENTER Uchendu Chukwudi B. 17304 Preston Rd Ste 555 Dallas TX 75252 20 08 1 None 1 2 1 32987072 96802979RICHARDSON MEDICAL CENTER Sokoya Gbolahan O. Hospital Care Consultants, Inc Dallas TX 75252 20 41 1 >=18 1 2 1 32987073 96799701LABCORP 3101 JOE RAMSEY BLVD E STE 105 GREENVILLE TX 75401 20 30 1 none 1 1 2 33121020 96113333Hanger Prosthetics & Orthotics West Inc. 3900 Joe Ramsey Boulevard Suite A-West Greenville TX 75401 40 53 1 none 1 1 2 33122550 96121165Quest Diagnostics 4101 Wesley St Ste G Greenville TX 75401 20 30 1 none 1 1 2 33128178 96108989Apria Healthcare, Inc. 7901 Traders Cir Greenville TX 75402 40 54 1 none 1 1 2 33091667 96106327LINCARE INC 1629 W. 16TH ST. MOUNT PLEASANT TX 75455 40 54 1 none 1 1 2 33167275 94987121Hanger Prosthetics & Orthotics West Inc. 2619 Northeast Loop 286 Suite A Paris TX 75460 40 53 1 none 1 1 2 33686600 95550900Quest Diagnostics 3306 Lamar Ave Ste B Paris TX 75460 20 30 1 none 1 1 2 33660714 95514774LINCARE INC 3741 LAMAR PARIS TX 75460 40 54 1 none 1 1 2 33662015 95507235Hanger Prosthetics & Orthotics West Inc. 1228 Church Street Suite D Sulphur Springs TX 75482 40 53 1 none 1 1 2 33154745 95599251Quest Diagnostics 921 Texas Blvd., Suite A Texarkana TX 75501 20 30 1 none 1 1 2 33427171 94049424UNITED MEDICAL 3505 SUMMERHILL SUITE 8 TEXARKANA TX 75503 40 54 1 none 1 1 2 33450587 94065473LABCORP 3505 SUMMERHILL RD STE 3 TEXARKANA TX 75503 20 30 1 none 1 1 2 33450587 94065473LINCARE INC 3909 N STATE LINE AVENUE TEXARKANA TX 75503 40 54 1 none 1 1 2 33454370 94043271Quest Diagnostics 603 N. Second Street Longview TX 75601 20 30 1 none 1 1 2 32499337 94733930LABCORP 815 N 4TH ST STE D LONGVIEW TX 75601 20 30 1 none 1 1 2 32504749 94731463Apria Healthcare, Inc. 1208 Champion Way Longview TX 75604 40 54 1 none 1 1 2 32485400 94762500LINCARE INC 522 EAST LOOP 281 SUITE A LONGVIEW TX 75605 40 54 1 none 1 1 2 32541848 94736859LINCARE INC 102 E CROCKETT MARSHALL TX 75670 40 54 1 none 1 1 2 32542355 94367195LABCORP 1040 S FLEISHEL AVE STE 3 TYLER TX 75701 20 30 1 none 1 1 2 32337546 95288615Hanger Prosthetics & Orthotics Inc. 2413 East 5Th Street Tyler TX 75701 40 53 1 none 1 1 2 32332082 95269625LINCARE INC 3015 EAST 5TH STREET TYLER TX 75701 40 54 1 none 1 1 2 32332385 95260781Quest Diagnostics 822 S. Fleishel Avenue Tyler TX 75701 20 30 1 none 1 1 2 32339936 95288648LINCARE INC 927 NORTH PALESTINE SUITE 101 ATHENS TX 75751 40 54 1 none 1 1 2 32217103 95853616RICHARDSON MEDICAL CENTER Lifshutz David M. 1304 Preston Rd Ste 555 Dallas TX 75752 20 02 1 none 1 2 1 32240664 95843349LINCARE INC 914 EAST GOODE STREET QUITMAN TX 75783 40 54 1 none 1 1 2 32795946 95436956LINCARE INC 201 WEST PALESTINE PALESTINE TX 75801 40 54 1 none 1 1 2 31770857 95634527LINCARE INC 1001 ELLIS AVE LUFKIN TX 75904 40 54 1 none 1 1 2 31336304 94738934Quest Diagnostics 503 Gaslight Blvd Lufkin TX 75904 20 30 1 none 1 1 2 31329267 94751379LABCORP 505 GASLIGHT BLVD GASLIGHT SQUARE LUFKIN TX 75904 20 30 1 none 1 1 2 31329245 94751387Hanger Prosthetics & Orthotics Inc. 521 Gaslight Boulevard Lufkin TX 75904 40 53 1 none 1 1 2 31328891 94751520SHELBY REGIONAL MEDICAL CENTER 602 Hurst Street Center TX 75935 60 86 1 none 1 2 2 31797299 94190588Apria Healthcare, Inc. 1004 North St Nacogdoches TX 75961 40 54 1 none 1 1 2 31611680 94653153LINCARE INC 711 E MAIN STREET NACOGDOCHES TX 75961 40 54 1 none 1 1 2 31601634 94650136Hanger Prosthetics & Orthotics Inc. 900 North Mound Street Nacogdoches TX 75961 40 53 1 none 1 1 2 31610723 94649341MEMORIAL MEDICAL CENTER SAN AUGUSTINE 511 Hospital St. San Augustine TX 75972 60 86 1 none 1 2 2 31531210 94105092

BAYLOR BARNETT TOWER

MEDICAL CTR BLDG


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

LABCORP 900 W RANDOL MILL RD STE 115 ARLINGTON TX 76012 20 30 1 none 1 1 2 32750007 97118440Quest Diagnostics 903 B Medical Centre Dr Arlington TX 76012 20 30 1 none 1 1 2 32740982 97115914

LABCORP 515 W MAYFIELD RD STE 401 ARLINGTON TX 76014 20 30 1 none 1 1 2 32691248 97112903Quest Diagnostics 1001 W Arbrook Blvd Suite 141 Arlington TX 76015 20 30 1 none 1 1 2 32682315 97121548Hanger Prosthetics & Orthotics West Inc. 3030 Matlock Road Suite 108 Arlington TX 76015 40 53 1 none 1 1 2 32694923 97115168Quest Diagnostics 124 Industrial Ave Azle TX 76020 20 30 1 none 1 1 2 32897790 97546604LABCORP 328 W MAIN ST STE 9 AZLE TX 76020 20 30 1 none 1 1 2 32895276 97546274Quest Diagnostics 1615 Hospital Pkwy Ste 208 Bedford TX 76022 20 30 1 none 1 1 2 32833362 97125530LABCORP 203 WALLS DR STE 102 MEDICAL PLAZA I CLEBURNE TX 76033 20 30 1 none 1 1 2 32330253 97445787Quest Diagnostics 505 N Ridgeway Dr Ste 172 Cleburne TX 76033 20 30 1 none 1 1 2 32345784 97411955LABCORP 350 WESTPARK WAY STE 104 EULESS TX 76040 20 30 1 none 1 1 2 32833120 97120023LABCORP 1205 MEDICAL PLAZA CT GRANBURY TX 76048 20 30 1 none 1 1 2 32436000 97811000Quest Diagnostics 805 Hill Blvd Ste 108 Granbury TX 76048 20 30 1 none 1 1 2 32435435 97772976Apria Healthcare, Inc. 401 Temple Hall Highway Suite 5 Granbury TX 76049 40 54 1 none 1 1 2 32470756 97715794Quest Diagnostics 1600 W. College St Suite 100 Grapevine TX 76051 20 30 1 none 1 1 2 32935749 97093035

LABCORP 1600 W.COLLEGE ST,STE LL30 GRAPEVINE TX 76051 20 30 1 none 1 1 2 32935749 97093035LABCORP 1643 LANCASTER DR STE 223 GRAPEVINE TX 76051 20 30 1 none 1 1 2 32932333 97092841Hanger Prosthetics & Orthotics West Inc. 1705 West Northwest Highway Suite 180 Grapevine TX 76051 40 53 1 none 1 1 2 32941002 97095047Hanger Prosthetics & Orthotics West Inc. 729 West Bedford Euless Road Hurst TX 76053 40 53 1 none 1 1 2 32833861 97184852LABCORP 1670 E BROAD ST STE 104 MANSFIELD TX 76063 20 30 1 none 1 1 2 32568543 97115617LABCORP 2800 E BROAD ST STE 424 METHODIST POB 1 MANSFIELD TX 76063 20 30 1 none 1 1 2 32569425 97094879Quest Diagnostics 990 U S Hwy. 287 North, Suite 115 Mansfield TX 76063 20 30 1 none 1 1 2 32582421 97131781Quest Diagnostics 2220 Bryan Pl Ste 108 Midlothian TX 76065 20 30 1 none 1 1 2 32458853 96941084Quest Diagnostics 1105 Sante Fe, Ste 103 Weatherford TX 76086 20 30 1 none 1 1 2 32748288 97782859LINCARE INC 210 SANTA FE DRIVE WEATHERFORD TX 76086 40 54 1 none 1 1 2 32757049 97791955LABCORP 750 EUREKA ST STE C WEATHERFORD TX 76086 20 30 1 none 1 1 2 32749928 97786529

LABCORP 1250 8TH AVE #335 FORT WORTH TX 76104 20 30 1 none 1 1 2 32731112 97343890Quest Diagnostics 1250 8th Avenue, Suite 115 Fort Worth TX 76104 20 30 1 none 1 1 2 32731112 97343890

LABCORP 1307 8TH AVE STE 106 FORT WORTH TX 76104 20 30 1 none 1 1 2 32730495 97343565Hanger Prosthetics & Orthotics Inc. 1401 West Magnolia Avenue Fort Worth TX 76104 40 53 1 none 1 1 2 32730509 97340445Quest Diagnostics 855 Montgomery St Ste 170 Fort Worth TX 76107 20 30 1 none 1 1 2 32751148 97369709Apria Healthcare, Inc. 120 E Felix Street #308 Fort Worth TX 76115 40 54 1 none 1 1 2 32677846 97326606

LABCORP 6823 GREEN OAKS RD STE C FORT WORTH TX 76116 20 30 1 none 1 1 2 32738801 97434080Quest Diagnostics 6855a Green Oaks Rd Ste 106 Fort Worth TX 76116 20 30 1 none 1 1 2 32736166 97435221

LABCORP 6210 JOHN RYAN DR STE 110 FORT WORTH TX 76132 20 30 1 none 1 1 2 32659352 97421944Quest Diagnostics 7555 Oakmont Blvd Fort Worth TX 76132 20 30 1 none 1 1 2 32662131 97423523LINCARE INC 5813 WESTCREEK DRIVE FORT WORTH TX 76133 40 54 1 none 1 1 2 32659212 97361752LABCORP 4504 BOAT CLUB RD STE 300 LAKE WORTH FORT WORTH TX 76135 20 30 1 none 1 1 2 32822037 97419852Quest Diagnostics 4625 Boat Club Rd Lake Worth TX 76135 20 30 1 none 1 1 2 32823373 97420180Quest Diagnostics 7630 N Beach St Ste 156 Fort Worth TX 76137 20 30 1 none 1 1 2 32878806 97289437LABCORP 4109 CAGLE DR STE A NORTH RICHLAND TX 76180 20 30 1 none 1 1 2 32826127 97214803

PROFESSIONAL PLAZA

COLUMBIA PROFESSIONAL BLDG.

BAYLOR MEDICAL CENTER

BAYLOR ALL SAINTS

MEDICAL ARTS BLDG

RIDGMAR PHARMACY

COOKS CHILDRENS BLDG


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

LABCORP 209 N BONNIE BRAE ST STE 203 DENTON TX 76201 20 30 1 none 1 1 2 33216698 97161615LINCARE INC 717 SOUTH I-35 E SUITE 132 DENTON TX 76205 40 54 1 none 1 1 2 33193685 97122627Quest Diagnostics 2817 S Mayhill Rd Suite 130 Denton TX 76208 20 30 1 none 1 1 2 33209700 97083700LABCORP 3331 COLORADO BLVD DENTON DENTON TX 76210 20 30 1 none 1 1 2 33179739 97089775Quest Diagnostics 3529 Heritage Trace Parkway Suite 133 Keller TX 76244 20 30 1 none 1 1 2 32913849 97305716Quest Diagnostics 260 N Rufe Snow Dr Keller TX 76248 20 30 1 none 1 1 2 32937648 97229456Quest Diagnostics 1508 Tenth St Ste 5 Wichita Falls TX 76301 20 30 1 none 1 1 2 33904855 98499760LABCORP 1518 10TH ST WICHITA FALLS TX 76301 20 30 1 none 1 1 2 33904780 98499899LINCARE INC 1501 MIDWESTERN PARKWAY SUITE 117 WICHITA FALLS TX 76302 40 54 1 none 1 1 2 33876995 98494533LINCARE INC 1225 NORTH MAIN STREET BELTON TX 76513 40 54 1 none 1 1 2 31067881 97459233Quest Diagnostics 2300 S Clear Creek Rd Ste 204 Killeen TX 76549 20 30 1 none 1 1 2 31111495 97800075LABCORP 3500 HILLCREST DR STE 2B WACO TX 76708 20 30 1 none 1 1 2 31555442 97180828Apria Healthcare, Inc. 4923 Franklin Ave Waco TX 76710 40 54 1 none 1 1 2 31521225 97173333LINCARE INC 508 MEADOWLAKE CENTER WACO TX 76712 40 54 1 none 1 1 2 31511100 97206900Quest Diagnostics 512 Meadowlake Ctr Waco TX 76712 20 30 1 none 1 1 2 31511100 97206900Apria Healthcare, Inc. 2400 Crockett Drive Suite 300 Brownwood TX 76801 40 54 1 none 1 1 2 31682117 98995434LINCARE INC 506 S IRVING SAN ANGELO TX 76903 40 54 1 none 1 1 2 31456086 ###Quest Diagnostics 2000 Crawford St Ste 855 Houston TX 77002 20 30 1 none 1 1 2 29746057 95366104LABCORP 2000 CRAWFORD ST STE 975 HOUSTON TX 77002 20 30 1 none 1 1 2 29746057 95366104LABCORP 1200 BINZ #140 HOUSTON TX 77004 20 30 1 none 1 1 2 29724532 95387779Quest Diagnostics 1200 Binz St Ste 115 Houston TX 77004 20 30 1 none 1 1 2 29724532 95387779Quest Diagnostics 1213 Hermann Dr Ste 120 Houston TX 77004 20 30 1 none 1 1 2 29723092 95388933

LABCORP 1213 HERMANN DR STE 155 HOUSTON TX 77004 20 30 1 none 1 1 2 29723092 95388933Quest Diagnostics 5711 Almeda Rd Ste.131b Ste #131b Houston TX 77004 20 30 1 none 1 1 2 29718461 95380089Quest Diagnostics 3400 Bissonnet St Ste 298 Houston TX 77005 20 30 1 none 1 1 2 29725495 95430268LABCORP 1631 NORTH LOOP WEST #630 HOUSTON TX 77008 20 30 1 none 1 1 2 29812138 95430772LABCORP 1740 W 27TH ST STE 311 MEMORIAL N. W. HOUSTON TX 77008 20 30 1 none 1 1 2 29810272 95429890Quest Diagnostics 1919 North Loop W Ste 125 Houston TX 77008 20 30 1 none 1 1 2 29811355 95433827

LABCORP 427 W 20TH ST STE 504 HOUSTON TX 77008 20 30 1 none 1 1 2 29804012 95404338LABCORP 15655 CYPRESSWOOD MEDICAL #130 HOUSTON TX 77014 20 30 1 none 1 1 2 29999929 95469056Quest Diagnostics 1140 Westmont Dr Ste 510 Houston TX 77015 20 30 1 none 1 1 2 29773173 95194723

LABCORP 902 FROSTWOOD DR STE 259 HOUSTON TX 77024 20 30 1 none 1 1 2 29779674 95547606

LABCORP 915 GESSNER RD 480 HOUSTON TX 77024 20 30 1 none 1 1 2 29783973 95448296Quest Diagnostics 915 Gessner Rd Ste 670 Houston TX 77024 20 30 1 none 1 1 2 29780394 95544704LABCORP 925 GESSNER #490 GESSNER PRO II HOUSTON TX 77024 20 30 1 none 1 1 2 29781236 95544530DiBello Dynamic Orthotics and Prosthetics Partners 11155 South Main Street Houston TX 77025 40 53 1 none 1 1 2 29664910 95437261LABCORP 6410 FANNIN ST STE 110 HOUSTON TX 77030 20 30 1 none 1 1 2 29714487 95397380Quest Diagnostics 6410 Fannin St Ste 220 Houston TX 77030 20 30 1 none 1 1 2 29714487 95397380Quest Diagnostics 7515 Main St Ste 160 Houston TX 77030 20 30 1 none 1 1 2 29698847 95410634LABCORP 7207 GESSNER DR MAINLAB HOUSTON TX 77040 20 30 1 none 1 1 2 29874327 95540967Hanger Prosthetics & Orthotics West Inc. 2525 West Bellfort Suite 155 Houston TX 77054 40 53 1 none 1 1 2 29672786 95418674LABCORP 7400 FANNIN ST STE 1200 HOUSTON TX 77054 20 30 1 none 1 1 2 29695470 95401010Quest Diagnostics 7400 Fannin St Ste 180 Houston TX 77054 20 30 1 none 1 1 2 29695470 95401010

PRESBYTERIAN MOB III

PARK PLAZA PROFESSIONAL BLDG

HEIGHTS MEDICAL TOWER

MEMORIAL CITY PROF BLDG I

MEMORIAL CITY GESSNER


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

LABCORP 7580 FANNIN ST STE 320 HOUSTON TX 77054 20 30 1 none 1 1 2 29693101 95401183Quest Diagnostics 7580 Fannin Suite 233 Houston TX 77054 20 30 1 none 1 1 2 29693101 95401183Quest Diagnostics 7900 Fannin St # 1700 Houston TX 77054 20 30 1 none 1 1 2 29689433 95403560Quest Diagnostics 8928 Kirby Dr Houston TX 77054 20 30 1 none 1 1 2 29674493 95412486Apria Healthcare, Inc. 9400 Kirby Drive Houston TX 77054 40 54 1 none 1 1 2 29666881 95413425Quest Diagnostics 8830 Long Point Rd Ste 101 Houston TX 77055 20 30 1 none 1 1 2 29803211 95507924LABCORP 8830 LONG POINT RD STE 705 SPRING BRANCH HOUSTON TX 77055 20 30 1 none 1 1 2 29803211 95507924Quest Diagnostics 2200 Nasa Rd 1 Ste 220 Nassau Bay TX 77058 20 30 1 none 1 1 2 29552419 95085552Quest Diagnostics 11454 Space Center Blvd. Ste.a Houston TX 77059 20 30 1 none 1 1 2 29628499 95142761LINCARE INC 450 N SAM HOUSTON PKWY E SUITE 108 HOUSTON TX 77060 40 54 1 none 1 1 2 29938276 95394935Quest Diagnostics 10680 Jones Road Suite # 200 Houston TX 77065 20 30 1 none 1 1 2 29929054 95584591Quest Diagnostics 11301 Fallbrook Dr Ste 108 Houston TX 77065 20 30 1 none 1 1 2 29925446 95589176

LABCORP 11301 FALLBROOK DR STE 207 HOUSTON TX 77065 20 30 1 none 1 1 2 29925446 95589176Quest Diagnostics 11811 Fm 1960 Rd W Ste 155 Houston TX 77065 20 30 1 none 1 1 2 29925146 95597525LABCORP 13215 DOTSON RD #120 WILLOWBROOK HOUSTON TX 77070 20 30 1 none 1 1 2 29967505 95553214Quest Diagnostics 13300 Hargrave Rd Ste 507 Houston TX 77070 20 30 1 none 1 1 2 29968455 95552002LABCORP 7737 SOUTHWEST FWY STE 305 MEM SW 7737 HOUSTON TX 77074 20 30 1 none 1 1 2 29694911 95523018LABCORP 7777 SOUTHWEST FWY STE 940 MEM SW 7777 HOUSTON TX 77074 20 30 1 none 1 1 2 29694612 95523346Quest Diagnostics 8200 Wednesbury Ln Houston TX 77074 20 30 1 none 1 1 2 29689312 95526156LABCORP 8313 SOUTHWEST FWY STE 111 THE CENTER HOUSTON TX 77074 20 30 1 none 1 1 2 29688608 95529520LABCORP 7007 NORTH FWY STE 235 HOUSTON TX 77076 20 30 1 none 1 1 2 29863660 95405176Quest Diagnostics 10837 Katy Fwy Ste 150 Houston TX 77079 20 30 1 none 1 1 2 29783871 95568322Quest Diagnostics 1201 Dairy Ashford St Ste 120 Houston TX 77079 20 30 1 none 1 1 2 29782259 95606683LABCORP 5420 DASHWOOD DR STE 205 BELLAIRE MEDICAL PHOUSTON TX 77081 20 30 1 none 1 1 2 29707568 95475036Quest Diagnostics 6550 Mapleridge St. Ste.#217 Houston TX 77081 20 30 1 none 1 1 2 29709911 95474373Quest Diagnostics 12121 Richmond Ave Ste 124 Houston TX 77082 20 30 1 none 1 1 2 29730455 95593517Quest Diagnostics 11717 Highland Meadow Dr Houston TX 77089 20 30 1 none 1 1 2 29587418 95209526LABCORP 17030 NANES DR STE 108 NANES HOUSTON TX 77090 20 30 1 none 1 1 2 30016803 95447324Quest Diagnostics 17070 Red Oak Dr Ste 106 Houston TX 77090 20 30 1 none 1 1 2 30018118 95444321LABCORP 17070 RED OAK DR STE 107 TEXAS TOWERS HOUSTON TX 77090 20 30 1 none 1 1 2 30018118 95444321Apria Healthcare, Inc. 255 Pennbright Suite 240 Houston TX 77090 40 54 1 none 1 1 2 29992372 95428501Quest Diagnostics 800 Peakwood Dr Ste 7c Houston TX 77090 20 30 1 none 1 1 2 30022257 95442839Quest Diagnostics 837 Fm 1960 Rd W Ste 100 Houston TX 77090 20 30 1 none 1 1 2 30017105 95442427LINCARE INC 4500 W 34TH ST HOUSTON TX 77092 40 54 1 none 1 1 2 29819798 95458368LINCARE INC 1414 S FRAZIER SUITE 101 CONROE TX 77301 40 54 1 none 1 1 2 30287406 95456432LABCORP 100 MEDICAL CENTER BLVD STE 114 CONROE TX 77304 20 30 1 none 1 1 2 30287901 95462896Quest Diagnostics 800 Riverwood Court Suite 103 Conroe TX 77304 20 30 1 none 1 1 2 30284495 95466056Quest Diagnostics 8901 Farm To Market 1960 Rd W Ste # 203 Humble TX 77338 20 30 1 none 1 1 2 30001574 95289843LABCORP 9816 MEMORIAL BLVD STE 105 HUMBLE TX 77338 20 30 1 none 1 1 2 29994014 95274695Quest Diagnostics 350 Kingwood Medical Dr. Ste.#120 Kingwood TX 77339 20 30 1 none 1 1 2 30051673 95247999LABCORP 102 MEDICAL PARK LN #B HUNTSVILLE TX 77340 20 30 1 none 1 1 2 30714600 95559700Apria Healthcare, Inc. 1223 Financial Plz Huntsville TX 77340 40 54 1 none 1 1 2 30714770 95569761Apria Healthcare, Inc. 1601 Highway 59 Loop N Ste 100 Livingston TX 77351 40 54 1 none 1 1 2 30696900 94954600LINCARE INC 306 W MILL ST LIVINGSTON TX 77351 40 54 1 none 1 1 2 30710193 94934996Quest Diagnostics 13406 Medical Complex Dr Ste 170 Tomball TX 77375 20 30 1 none 1 1 2 30084688 95623011LABCORP 506 Graham Suite 260 ATRIUM BLDG. TOMBALL TX 77375 20 30 1 none 1 1 2 30088700 95621500

WOMEN'S HOSPITAL COMPLEX

STEEPLECHASE PROFESSIONAL BLDG


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

LABCORP 1001 MEDICAL PLAZA DR STE 180 THE WOODLANDS SPRING TX 77380 20 30 1 none 1 1 2 30172502 95453356Quest Diagnostics 8850 6 Pines Dr Ste 230 The Woodlands TX 77380 20 30 1 none 1 1 2 30155113 95459840DiBello Dynamic Orthotics and Prosthetics Partners 19221 I-45 North Suite 110 Shenandoah TX 77385 40 53 1 none 1 1 2 30224727 95452202Quest Diagnostics 6565 West Loop S Ste 302 Bellaire TX 77401 20 30 1 none 1 1 2 29709382 95459472

LABCORP 720 AVENUE F N STE 5 BAY CITY TX 77414 20 30 1 none 1 1 2 29010604 95973807LABCORP 21700 KINGSLAND BLVD STE 108 KATY TX 77450 20 30 1 none 1 1 2 29775189 95745150Quest Diagnostics 952 S Fry Rd Katy TX 77450 20 30 1 none 1 1 2 29771166 95719147Quest Diagnostics 1601 Main St Ste 208 Richmond TX 77469 20 30 1 none 1 1 2 29577099 95768846

LABCORP 1601 MAIN ST STE 405 RICHMOND TX 77469 20 30 1 none 1 1 2 29577099 95768846DiBello Dynamic Orthotics and Prosthetics Partners 4915 South Main #115 Stafford TX 77477 40 53 1 none 1 1 2 29628321 95588620

LABCORP 1211 HIGHWAY 6 STE 60 SUGAR LAND TX 77478 20 30 1 none 1 1 2 29604259 95635710Quest Diagnostics 2205 Williams Trace Blvd Ste 107 Sugar Land TX 77478 20 30 1 none 1 1 2 29595271 95603559

LABCORP 16659 SOUTHWEST FWY STE 301 SUGAR LAND TX 77479 20 30 1 none 1 1 2 29590031 95632344Quest Diagnostics 4907 Sandhill Dr Suite E Sugar Land TX 77479 20 30 1 none 1 1 2 29599596 95682143LABCORP 4911 SANDHILL DR A SUGAR LAND TX 77479 20 30 1 none 1 1 2 29607085 95642739LABCORP 1331 W GRAND PKWY N #342 KATY TX 77493 20 30 1 none 1 1 2 29791155 95777551Quest Diagnostics 1331 W Grand Pkwy N Katy Ste 343 Katy TX 77493 20 30 1 none 1 1 2 29813307 95792734HOME OXYGEN 2-U 2900 KATY HOCKLEY CUTOFF SUITE B202 KATY TX 77493 40 54 1 none 1 1 2 29816056 95808411LINCARE INC 6193 HWY BOULEVARD SUITE 210 KATY TX 77494 40 54 1 none 1 1 2 29740774 95859571Quest Diagnostics 3315 Burke Rd Ste 106 Pasadena TX 77504 20 30 1 none 1 1 2 29661478 95186143

LABCORP 3801 VISTA RD STE 390 PASADENA TX 77504 20 30 1 none 1 1 2 29658803 95184146LABCORP 5119 Fairmont Suite C PASADENA TX 77505 20 30 1 none 1 1 2 29650017 95164446Quest Diagnostics 6243 Fairmont Pkwy Ste 203 Pasadena TX 77505 20 30 1 none 1 1 2 29650510 95144515Quest Diagnostics 2802 Garth Rd Ste 213 Baytown TX 77521 20 30 1 none 1 1 2 29751256 94977272LINCARE INC 3630 GARTH ROAD BAYTOWN TX 77521 40 54 1 none 1 1 2 29761589 94977210Quest Diagnostics 407 W Baker Rd Ste X Baytown TX 77521 20 30 1 none 1 1 2 29769595 94967467Apria Healthcare, Inc. 6612 Garth Rd Baytown TX 77521 40 54 1 none 1 1 2 29797925 94980732LINCARE INC 833 W PLANTATION CLUTE TX 77531 40 54 1 none 1 1 2 29017065 95415526Quest Diagnostics 355 A. E Parkwood Friendswood TX 77546 20 30 1 none 1 1 2 29518817 95215508Hanger Prosthetics & Orthotics Inc. 625 University Boulevard Galveston TX 77550 40 53 1 none 1 1 2 29308086 94773793LINCARE INC 6012 AVENUE T GALVESTON TX 77551 40 54 1 none 1 1 2 29273610 94828801Quest Diagnostics 120 Circle Way St Ste 1d Lake Jackson TX 77566 20 30 1 none 1 1 2 29042215 95451864

LABCORP 135 OYSTER CREEK DR STE P LAKE JACKSON TX 77566 20 30 1 none 1 1 2 29045086 95449776Quest Diagnostics 14025 Delaney Rd. La Marque TX 77568 20 30 1 none 1 1 2 29384752 95020892Apria Healthcare, Inc. 400 Hobbs Road Ste 211 League City TX 77573 40 54 1 none 1 1 2 29498124 95115552Hanger Prosthetics & Orthotics Inc. 17324 - B Highway 3 Webster TX 77598 40 53 1 none 1 1 2 29541804 95122122LABCORP 250 BLOSSOM ST STE 270 WEBSTER TX 77598 20 30 1 none 1 1 2 29543736 95126093Quest Diagnostics 561 Medical Center Blvd. Webster TX 77598 20 30 1 none 1 1 2 29539823 95127452LABCORP 228 STRICKLAND DR ORANGE TX 77630 20 30 1 none 1 1 2 30096825 93765022Quest Diagnostics 230 Strickland Dr Orange TX 77630 20 30 1 none 1 1 2 30096831 93765028KOTHAPALLI SRINIVASA R MD Kothapalli Srinivasa Rao MD 2501 Jimmy Johnson Blvd Ste 500 Port Arthur TX 77640 20 06 1 >=18 1 2 2 29934784 93985622LABCORP 2501 JIMMY JOHNSON BLVD 209 PORT ARTHUR TX 77640 20 30 1 none 1 1 2 29889390 93936277KOTHAPALLI SRINIVASA R MD Buheis Nidal I. MD 2501 Jimmy Johnson Blvd #500 Port Arthur TX 77640 20 06 1 >=18 1 2 2 29934784 93985622Quest Diagnostics 2501 Jimmy Johnson Blvd Ste 303 Port Arthur TX 77640 20 30 1 none 1 1 2 29934784 93985622

OAK TREE PROF BLD

OAK BEND DR'S CNTR

SUGARLAND HLTH CNTR

PHY AT SWEETWATER

BAYSHORE MED TOWER BLDG

OYSTER CREEK PROF CTR


LOI Contract STP*

Geocoding



Provider Type

Specialty Code

New Patient

Age Restricti

onPCP Link

Middle Initial

2nd Line of Address

Postal Code

Hanger Prosthetics & Orthotics Inc. 7675 Memorial Boulevard Port Arthur TX 77640 40 53 1 none 1 1 2 29937661 93983216Apria Healthcare, Inc. 3077 Calder Ave Beaumont TX 77702 40 54 1 none 1 1 2 30085399 94134001LINCARE INC 2150 NORTH 11TH ST BEAUMONT TX 77703 40 54 1 none 1 1 2 30098808 94129903

Legend:

association/group name, if applicable.

1st line of address, 2nd line of address, City, State, and Postal Code. Do not include P.O. Box in the address.

if Yes or "2" if No.

1. Provider/Practice Name - Indicate the name of the provider. For practitioners indicate the professional

2. Practitioner Name - Only complete for practitioners. Specify the practitioner’s name and title. Last Name - Specify the last name of the practitioner. First Name - Specify the first name of the practitioner. Title - Specify the practitioner's title such as MD, NP (Nurse Practitioner), PA (Physician Assistant), etc.3. Business Location Address - Indicate the business location address where services are provided including but not limited to,

4. Provider Type - Specify the two digit Medicaid provider type code.5. Specialty Code - Specify the two digit Medicaid specialty type code.6. New Patient - Indicate whether or not the provider is accepting new patients. If accepting new patients specify "1"

7. Age Restriction - Indicate any age restrictions for the provider’s practice. For instance, if a physician only sees patients up to age 19, indicate "< 19"; if a physician only sees patients age 13 or above, indicate "≥13".8. PCP Linkages - If PCP - specify the number of potential linkages.9. LOI - Letter of Intent - If a Letter of Intent has been executed specify "1" if Yes or "2" if No.10. Contract - If a Contract has been executed specify "1" if Yes or "2" if No.11. STP* - If network provider meets the definition of Significant Traditional Provider, specify "1" if Yes or "2" if No..12. Geocoding - Specify the latitude and longitude in decimal (dd) format. (ie. 32.7834 -91.12345)

*STP Report is available on the MakingMedicaidBetter.com website.

ldh.la.govldh.la.gov/assets/docs/making_medicaid_better/resources/ccn_rfp... · xls file · web...

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