| Dr Ernest Kelly, MD | |
|
2495 Shreveport Hwy, Pineville, LA 71360-4044 | |
| (318) 473-0010 | |
| (318) 473-1435 |
| Full Name | Dr Ernest Kelly |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 2495 Shreveport Hwy, Pineville, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740381953 | NPI | - | NPPES |
| 1340146 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 016942 (Louisiana) | Primary |
| 208000000X | Pediatrics | 016942 (Louisiana) | Secondary |
| Entity Name | Central La State Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831220706 PECOS PAC ID: 4981689833 Enrollment ID: O20040623001036 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ernest Kelly, MD 2495 Shreveport Hwy, Pineville, LA 71360-4044 Ph: (318) 473-0010 | Dr Ernest Kelly, MD 2495 Shreveport Hwy, Pineville, LA 71360-4044 Ph: (318) 473-0010 |
Dr. John Winston Miller, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 352 Hospial Boulevard, Pineville, LA 71361 Phone: 318-448-0811 Fax: 318-473-6395 | |
Jose Gonzalo Zavaleta, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1804 W Medalist Rd, Pineville, LA 71360 Phone: 318-641-7800 | |
Jorge Isaac Tapia, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2114 Shreveport Hwy, #226, Pineville, LA 71360 Phone: 318-473-2101 |