| Dr Larry Wedell Warner Jr, MD | |
| 10517 Kentshire Ct, Baton Rouge, LA 70810-2853 | |
| (225) 456-2884 | |
| (225) 456-2892 | 
| Full Name | Dr Larry Wedell Warner Jr | 
|---|---|
| Gender | Male | 
| Speciality | Psychiatry & Neurology - Psychiatry | 
| Location | 10517 Kentshire Ct, Baton Rouge, Louisiana | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1851552806 | NPI | - | NPPES | 
| 1035912 | Medicaid | LA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD61561495 (Washington) | Secondary | 
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 203545 (Louisiana) | Primary | 
| Entity Name | Our Lady Of The Lake Physician Group Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Larry Wedell Warner Jr, MD 10517 Kentshire Ct, Baton Rouge, LA 70810-2853 Ph: (225) 456-2884 | Dr Larry Wedell Warner Jr, MD 10517 Kentshire Ct, Baton Rouge, LA 70810-2853 Ph: (225) 456-2884 | 
| Dr. Donna Brian Fargason, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 9311a Bluebonnet Blvd, Baton Rouge, LA 70810 Phone: 225-769-5551 Fax: 225-769-5583 | |
| Kishore M Gadde, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 6400 Perkins Rd, Baton Rouge, LA 70808 Phone: 225-763-2552 | |
| Joseph Anthony Grizzaffi Jr., M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 5131 Odonovan Dr, Ste 300, Baton Rouge, LA 70808 Phone: 225-374-0400 Fax: 225-374-0430 | |
| Abdul Baset Khan, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 9001 Summa Ave, Baton Rouge, LA 70809 Phone: 225-761-5200 Fax: 225-761-5654 | |
| Gerard Dynes, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 7373 Perkins Rd, Baton Rouge, LA 70808 Phone: 225-769-4044 | |
| Dr. Kari Akili Jones, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 7521 Kings Hill Ave, Baton Rouge, LA 70810 Phone: 225-267-7141 | |
| Dr. Ashok Reddy Polu, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 5000 Hennessy Blvd, Baton Rouge, LA 70808 Phone: 225-765-6565 |