| Dr Trevor C Richard, MD | |
|
2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | |
| (225) 647-8511 | |
| (225) 644-5213 |
| Full Name | Dr Trevor C Richard |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 2647 S Saint Elizabeth Blvd, Gonzales, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588875017 | NPI | - | NPPES |
| 07946 | Medicaid | LA | |
| 1079464 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | 202291 (Louisiana) | Secondary |
| 207R00000X | Internal Medicine | 202291 (Louisiana) | Primary |
| Entity Name | East Carroll Parish Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982695441 PECOS PAC ID: 1153216619 Enrollment ID: O20040216000563 |
| Entity Name | Our Lady Of Lake Ascension, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306899067 PECOS PAC ID: 3577452259 Enrollment ID: O20040311000822 |
| Entity Name | Correct Care, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215987441 PECOS PAC ID: 8628980992 Enrollment ID: O20040816000150 |
| Entity Name | Emergency Staffing Solutions Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477590974 PECOS PAC ID: 9830001650 Enrollment ID: O20050610000177 |
| Entity Name | St Helena Parish Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1588614036 PECOS PAC ID: 6901893205 Enrollment ID: O20100115000573 |
| Entity Name | St Helena Parish Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1013068808 PECOS PAC ID: 6901893205 Enrollment ID: O20100115000596 |
| Entity Name | St. Martin Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528312584 PECOS PAC ID: 0446495410 Enrollment ID: O20130321000353 |
| Entity Name | Jena Ess Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235544115 PECOS PAC ID: 7810116258 Enrollment ID: O20140916002675 |
| Entity Name | Jena Ess Hospitalist Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144635020 PECOS PAC ID: 5294954533 Enrollment ID: O20140918000317 |
| Entity Name | Oakdale Ess Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750785119 PECOS PAC ID: 7517289713 Enrollment ID: O20141125000402 |
| Entity Name | Hub City Physician Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992180566 PECOS PAC ID: 3173831211 Enrollment ID: O20151009000080 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Trevor C Richard, MD 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 Ph: (225) 647-8511 | Dr Trevor C Richard, MD 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 Ph: (225) 647-8511 |
Mydhili Kanumilli, M.D Internal Medicine Medicare: Medicare Enrolled Practice Location: 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737 Phone: 225-647-8511 Fax: 225-644-5213 | |
Niksad Abraham, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2647 S Saint Elizabeth Blvd Ste 300, Gonzales, LA 70737 Phone: 225-767-3900 Fax: 225-766-2226 | |
Mason Wade Rau, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2647 S Saint Elizabeth Blvd Ste 219, Gonzales, LA 70737 Phone: 225-647-8511 Fax: 225-644-8358 | |
Dr. Gretchen Marie Yandle, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737 Phone: 225-647-8511 Fax: 225-644-5213 | |
Dr. Rahil Devendra Shah, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1014 Saint Clair Blvd Ste 3030, Gonzales, LA 70737 Phone: 225-765-5500 Fax: 225-743-2546 | |
Dr. Carlos R Vazquez, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2211 S Burnside Ave, Ste 4, Gonzales, LA 70737 Phone: 225-647-1947 | |
Bernard B Brach, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 2647 S. St Elizabeth Blvd, Gonzales, LA 70737 Phone: 225-647-8511 Fax: 225-644-5213 |