| Destin R Black, MD | |
|
2600 Kings Hwy, Suite 420, Shreveport, LA 71103-3950 | |
| (318) 212-8727 | |
| (318) 212-8771 |
| Full Name | Destin R Black |
|---|---|
| Gender | Female |
| Speciality | Gynecological Oncology |
| Experience | 26 Years |
| Location | 2600 Kings Hwy, Shreveport, Louisiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306062625 | NPI | - | NPPES |
| 1577936 | Medicaid | LA | |
| 4K574F600 | Other | LA | MEDICARE - PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207VX0201X | Obstetrics & Gynecology - Gynecologic Oncology | 024725 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Willis Knighton Medical Center, Inc | Shreveport, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wk Gynecologic Oncology Clinic | 3779683115 | 5 |
| Entity Name | Wk Gynecologic Oncology Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740493923 PECOS PAC ID: 3779683115 Enrollment ID: O20070713000387 |
| Mailing Address | Practice Location Address |
|---|---|
| Destin R Black, MD 2600 Kings Hwy, Suite 420, Shreveport, LA 71103-3950 Ph: (318) 212-8727 | Destin R Black, MD 2600 Kings Hwy, Suite 420, Shreveport, LA 71103-3950 Ph: (318) 212-8727 |
Sabrina Benefield Castle, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 2510 W. Bert Kouns Industrial Loop, Shreveport, LA 71118 Phone: 318-212-5000 Fax: 903-553-7751 | |
Rodney Wise, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 1501 Kings Hwy, Dept Of Ob/gyn, Shreveport, LA 71103 Phone: 318-675-8700 Fax: 318-675-8706 | |
James Barrow, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1501 Kings Hwy, Department Of Ob Gyn, Shreveport, LA 71103 Phone: 318-675-5000 | |
Melissa Fett Jordan, Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 3100 Fairfield Ave, Unit 10a, Shreveport, LA 71104 Phone: 318-201-3939 | |
Russell D Burlison, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1455 E Bert Koun Loop, Shreveport, LA 71105 Phone: 318-798-4400 Fax: 318-798-4525 | |
Dr. Ricky Allen Paul, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 8001 Youree Dr Ste 600, Shreveport, LA 71115 Phone: 318-212-3890 Fax: 318-212-3888 | |
Amanda Hammad Bunton, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 2508 Bert Koun Loop, Suite 201, Shreveport, LA 71118 Phone: 318-212-5790 Fax: 318-212-5795 |