Dr Vincent Cody Godinich, MD | |
7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 | |
(318) 642-9282 | |
Not Available |
Full Name | Dr Vincent Cody Godinich |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 7551 Youree Dr Ste 11, Shreveport, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588292049 | NPI | - | NPPES |
2524879 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 337011 (Louisiana) | Primary |
Entity Name | Centerwell Senior Primary Care La Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760005136 PECOS PAC ID: 1951712280 Enrollment ID: O20210217000212 |
Mailing Address | Practice Location Address |
---|---|
Dr Vincent Cody Godinich, MD 512 Wilson Rd, Harleton, TX 75651-4126 Ph: (903) 407-2605 | Dr Vincent Cody Godinich, MD 7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 Ph: (318) 642-9282 |
Ratnam Baby Nagalla, M.D Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 870 Olive St, Shreveport, LA 71104 Phone: 318-629-0480 Fax: 318-629-0483 | |
David Juston Colvin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8383 Millicent Way, Shreveport, LA 71115 Phone: 318-797-6661 Fax: 318-795-8512 | |
Susan Michelle Self, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8001 Youree Dr, Suite 540, Shreveport, LA 71115 Phone: 318-212-3810 Fax: 318-212-3815 | |
Jaya R Mcsharma, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 700 Texas St Ste 101, Shreveport, LA 71101 Phone: 318-777-6843 Fax: 318-625-5520 | |
Dr. Kirk Anthony Grantham, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2530 Bert Kouns Loop, Suite 138, Shreveport, LA 71118 Phone: 318-588-4726 Fax: 318-900-7828 | |
Ammar Husan, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Dr. Jode Jann Burgin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9220 Ellerbe Rd, Suite 700, Shreveport, LA 71106 Phone: 318-681-5282 Fax: 318-681-5284 |