| Dr Cary F Gray, MD | |
|
1150 Robert Blvd, Suite 220, Slidell, LA 70458-2004 | |
| (985) 646-4444 | |
| (985) 646-4448 |
| Full Name | Dr Cary F Gray |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 1150 Robert Blvd, Slidell, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659467488 | NPI | - | NPPES |
| 00011676 | Medicaid | MS | |
| 1303755 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | LO13790 (Louisiana) | Primary |
| Entity Name | East Jefferson Physicians Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922293372 PECOS PAC ID: 4587660402 Enrollment ID: O20090127000299 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Cary F Gray, MD 1150 Robert Blvd, Suite 220, Slidell, LA 70458-2004 Ph: (985) 646-4444 | Dr Cary F Gray, MD 1150 Robert Blvd, Suite 220, Slidell, LA 70458-2004 Ph: (985) 646-4444 |
Kevin T Lynch, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1001 Gause Blvd, Slidell, LA 70458 Phone: 985-280-2200 | |
Francis J Petitto Iii, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1051 Gause Blvd Ste 410, Slidell, LA 70458 Phone: 985-280-9002 Fax: 985-781-0200 | |
Dr. Heather Rae Bronaugh, MD Surgery Medicare: Medicare Enrolled Practice Location: 1051 Gause Blvd Ste 410, Slidell, LA 70458 Phone: 985-280-9002 Fax: 985-781-0200 | |
Richard Thomas Leblanc Jr., M.D Surgery Medicare: Accepting Medicare Assignments Practice Location: 2750 East Gause Blvd., Slidell, LA 70461 Phone: 985-639-3777 Fax: 985-646-4448 | |
Diana L Gillmore, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 985 Robert Blvd, #103, Slidell, LA 70458 Phone: 985-646-1884 Fax: 985-646-1885 | |
Paul Russell Hastings I, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1108 Crystal Ct, Slidell, LA 70461 Phone: 985-781-0015 | |
Robert V Shafor, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1051 Gause Blvd Ste 410, Slidell, LA 70458 Phone: 985-280-9002 Fax: 985-781-0200 |