Mr Glenn Michael Waguespack, MS | |
1455 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5634 | |
(318) 798-4442 | |
(318) 798-4439 |
Full Name | Mr Glenn Michael Waguespack |
---|---|
Gender | Male |
Speciality | Qualified Audiologist |
Experience | 54 Years |
Location | 1455 E Bert Kouns Industrial Loop, Shreveport, Louisiana |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255506291 | NPI | - | NPPES |
1688568 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | 416 (Louisiana) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Highland Clinic, A Prof Med Corp | 3870493463 | 49 |
Provider Name | Highland Clinic, A Prof Med Corp |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1053315846 PECOS PAC ID: 3870493463 Enrollment ID: O20040220000551 |
Mailing Address | Practice Location Address |
---|---|
Mr Glenn Michael Waguespack, MS 1455 East Bert Kouns Loop, Shreveport, LA 71105-5634 Ph: (318) 798-4442 | Mr Glenn Michael Waguespack, MS 1455 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5634 Ph: (318) 798-4442 |
Allied Health Clinics Audiologist Medicare: Not Enrolled in Medicare Practice Location: 3735 Blair Dr, Shreveport, LA 71103 Phone: 318-813-2962 Fax: 318-813-2981 | |
Mr. Dwayne Edward Redman, M.S., CCC-A Audiologist Medicare: Not Enrolled in Medicare Practice Location: 510 E Stoner Ave, Shreveport, LA 71101 Phone: 318-424-6090 Fax: 318-429-5749 | |
Leigh Anne Norman, M.S., CCC-A Audiologist Medicare: Not Enrolled in Medicare Practice Location: 2530 Bert Koun Loop, Suite 131, Shreveport, LA 71118 Phone: 318-212-5488 Fax: 318-212-5403 | |
Mrs. Jill Cooper Gaudet, M.A., CCC-A Audiologist Medicare: Not Enrolled in Medicare Practice Location: 2533 Bert Kouns Industrial Loop, Suite 104, Shreveport, LA 71118 Phone: 318-518-8530 Fax: 318-688-8861 | |
Ms. Shannon Colleen Mccole, AUD Audiologist Medicare: Medicare Enrolled Practice Location: 7847 Youree Dr, Shreveport, LA 71105 Phone: 318-212-3960 Fax: 318-212-3907 | |
Kimberly Renfro, AU.D. Audiologist Medicare: Not Enrolled in Medicare Practice Location: 510 E Stoner Ave, Shreveport, LA 71101 Phone: 318-426-0130 |