| Healthsource Of Mandeville, Llc | |
|
2480 N Causeway Blvd, Mandeville, LA 70471-1867 | |
| (985) 634-1112 | |
| Not Available |
| Full Name | Healthsource Of Mandeville, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 2480 N Causeway Blvd, Mandeville, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568175552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Stewart B Fresh |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1710921671 PECOS PAC ID: 3870505688 Enrollment ID: I20060619000085 |
| Provider Name | Jonathan P Doty |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1255834438 PECOS PAC ID: 9537423223 Enrollment ID: I20180504000829 |
| Provider Name | Christopher Michael Lizana |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1093222671 PECOS PAC ID: 2567711609 Enrollment ID: I20180822002054 |
| Mailing Address | Practice Location Address |
|---|---|
| Healthsource Of Mandeville, Llc 2480 N Causeway Blvd, Mandeville, LA 70471-1867 Ph: () - | Healthsource Of Mandeville, Llc 2480 N Causeway Blvd, Mandeville, LA 70471-1867 Ph: (985) 634-1112 |
James Joseph Derbes, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 235 West Florida St, Mandeville, LA 70448 Phone: 985-626-7795 | |
Bart C Sellers, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 221 Saint Ann Dr, Ste 2, Mandeville, LA 70471 Phone: 985-624-9888 Fax: 985-624-2572 | |
Taylor Elizabeth Ruppert, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 102 Fontainbleau Dr # D1, Mandeville, LA 70471 Phone: 985-789-1720 | |
Shelley Radosta, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1357 N Causeway Blvd, Ste 2, Mandeville, LA 70471 Phone: 985-778-0880 Fax: 985-778-0882 | |
Dr. Brandon Matthew Broadus, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 102 Fontainbleau Dr # D1, Mandeville, LA 70471 Phone: 985-400-5300 Fax: 985-400-5301 | |
Dr. Justin Schexnaildre, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 102 Fontainbleau Dr Ste D1, Mandeville, LA 70471 Phone: 985-400-5300 Fax: 985-400-5301 | |
Dr. Lawrence Westley Gamble, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 3573 Us-190, Suite F, Mandeville, LA 70471 Phone: 985-260-8863 |