| Dr Bruce R Knox, MD | |
|
3114 Lake St, Lake Charles, LA 70601-8338 | |
| (337) 562-0696 | |
| (337) 474-1378 |
| Full Name | Dr Bruce R Knox |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 38 Years |
| Location | 3114 Lake St, Lake Charles, 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 |
|---|---|---|---|
| 1477509743 | NPI | - | NPPES |
| 243024 | Medicaid | OR | |
| 05583595 | Medicaid | MS | |
| 1972053 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 09838R (Louisiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Radiology Specialists Llc | 6305749839 | 3 |
| Entity Name | Radiology Specialists Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811997125 PECOS PAC ID: 6305749839 Enrollment ID: O20040130000750 |
| Entity Name | Northwest Imaging Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568556256 PECOS PAC ID: 1153349683 Enrollment ID: O20051103000506 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Bruce R Knox, MD 3114 Lake St, Lake Charles, LA 70601-8338 Ph: (337) 562-0696 | Dr Bruce R Knox, MD 3114 Lake St, Lake Charles, LA 70601-8338 Ph: (337) 562-0696 |
John R Romero Iii, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1800 Ryan St, Suite 105, Lake Charles, LA 70601 Phone: 337-439-4706 Fax: 337-439-8110 | |
Richard L Martinez, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1800 Ryan St, Suite 105, Lake Charles, LA 70601 Phone: 337-439-4706 Fax: 337-439-8110 | |
James G Maze, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1701 Oak Park Blvd, Lake Charles, LA 70601 Phone: 337-494-2121 Fax: 337-494-2360 | |
Donald A Woolridge, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1800 Ryan St, Suite 105, Lake Charles, LA 70601 Phone: 337-439-4706 Fax: 337-439-8110 | |
Charles J Brdlik, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1800 Ryan St, Suite 105, Lake Charles, LA 70601 Phone: 337-439-4706 Fax: 337-439-8110 | |
Adam D Olsan, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1800 Ryan St, Suite 105, Lake Charles, LA 70601 Phone: 337-439-4706 Fax: 337-439-8110 | |
Dr. David R Wallace Jr., M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1800 Ryan St Ste 105, Lake Charles, LA 70601 Phone: 337-439-4706 Fax: 337-439-8110 |