| Donald Severinus Gervais Jr, MD | |
|
128 Neuroscience Ct, Gray, LA 70359 | |
| (985) 917-3007 | |
| (985) 917-3010 |
| Full Name | Donald Severinus Gervais Jr |
|---|---|
| Gender | Male |
| Speciality | Neurology |
| Experience | 30 Years |
| Location | 128 Neuroscience Ct, Gray, 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 |
|---|---|---|---|
| 1750387676 | NPI | - | NPPES |
| 1697508 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | MD.022617 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Francis Medical Center | Monroe, LA | Hospital |
| Our Lady Of Lourdes Regional Medical Center, Inc | Lafayette, LA | Hospital |
| Lafayette Surgical Specialty Hospital | Lafayette, LA | Hospital |
| Opelousas General Health System | Opelousas, LA | Hospital |
| Thibodaux Regional Medical Center | Thibodaux, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Neuro Diagnostic Monitoring, Llc | 5698939841 | 4 |
| Southeast Neuroscience Center, Llc | 9032010558 | 8 |
| Entity Name | Southeast Neuroscience Center, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285630129 PECOS PAC ID: 9032010558 Enrollment ID: O20040505000063 |
| Entity Name | Neuro Diagnostic Monitoring, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598030181 PECOS PAC ID: 5698939841 Enrollment ID: O20120619000630 |
| Entity Name | Neurotech Of Louisiana Llc |
|---|---|
| Entity Type | Part B Supplier - Independent Diagnostic Testing Facility (idtf) |
| Entity Identifiers | NPI Number: 1598001794 PECOS PAC ID: 5294057642 Enrollment ID: O20141215000314 |
| Mailing Address | Practice Location Address |
|---|---|
| Donald Severinus Gervais Jr, MD Po Box 1930, Gray, LA 70359-1930 Ph: (985) 917-3007 | Donald Severinus Gervais Jr, MD 128 Neuroscience Ct, Gray, LA 70359 Ph: (985) 917-3007 |
Edward Stewart Haight, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 128 Neuroscience Ct, Gray, LA 70359 Phone: 985-917-3007 Fax: 985-447-4209 |