| Dr Vincent D Mallory, MD | |
|
2495 Shreveport Hwy, Pineville, LA 71360-4044 | |
| (318) 466-2106 | |
| Not Available |
| Full Name | Dr Vincent D Mallory |
|---|---|
| Gender | Male |
| Speciality | Family 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 |
|---|---|---|---|
| 1215918503 | NPI | - | NPPES |
| 1574520 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 015979 (Louisiana) | Primary |
| Entity Name | Healogics Specialty Physicians Of Louisiana, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134528623 PECOS PAC ID: 9931425931 Enrollment ID: O20150311000165 |
| Entity Name | Hospitalist Medicine Physicians Of Texas Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629307095 PECOS PAC ID: 3476688318 Enrollment ID: O20151021000365 |
| Entity Name | Cogent Healthcare Of Texas Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992722953 PECOS PAC ID: 8628076924 Enrollment ID: O20190923002250 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Vincent D Mallory, MD 2495 Shreveport Hwy, Pineville, LA 71360-4044 Ph: (318) 466-2106 | Dr Vincent D Mallory, MD 2495 Shreveport Hwy, Pineville, LA 71360-4044 Ph: (318) 466-2106 |
Mr. Jonathan S Forester, MD MS Family Medicine Medicare: Medicare Enrolled Practice Location: 2809 Donahue Ferry Rd, Pineville, LA 71360 Phone: 318-641-0865 Fax: 318-640-3290 | |
Dr. James Edwards Wallace Jr., MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1135 Expressway Dr, Suite 200 A, Pineville, LA 71360 Phone: 318-561-9600 Fax: 318-561-0228 | |
Ms. Teresa Elena Hamm, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2495 Shreveport Hwy, Pineville, LA 71360 Phone: 318-473-0010 | |
Dametria A Sinegal-daniel, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 352 Hospital Blvd, Pineville, LA 71360 Phone: 318-448-0811 Fax: 318-473-1435 | |
Trung Dang Le, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 2495 Shreveport Hwy, Pineville, LA 71360 Phone: 318-466-4321 | |
Mary Emelee Benjamin, N.P. Family Medicine Medicare: Medicare Enrolled Practice Location: 2495 Shreveport Hwy Ste 104, Pineville, LA 71360 Phone: 318-466-4522 Fax: 318-445-1663 |