| Dr Gary Lane Wease, MD | |
|
201 S. Arkansas Street, Leesville, LA 71446 | |
| (337) 239-7227 | |
| (337) 238-4922 |
| Full Name | Dr Gary Lane Wease |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 35 Years |
| Location | 201 S. Arkansas Street, Leesville, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538200381 | NPI | - | NPPES |
| 2649345 | Medicaid | LA | |
| 3434512 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 339940 (Louisiana) | Primary |
| 208600000X | Surgery | 339940 (Louisiana) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Byrd Regional Hospital | Leesville, LA | Hospital |
| Sabine Medical Center | Many, LA | Hospital |
| Lasalle General Hospital | Jena, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Glen D. Hurlston, M.d., Apmc | 3779557541 | 26 |
| Jena Ess Llc | 7810116258 | 15 |
| Clhg-leesville | 4082963301 | 25 |
| Hodges Emergency Group Llc | 2567703978 | 19 |
| Entity Name | Glen D. Hurlston, M.D., APMC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306913488 PECOS PAC ID: 3779557541 Enrollment ID: O20040826000006 |
| Entity Name | Northern Louisiana Emergency Physicians, LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588828172 PECOS PAC ID: 9638246846 Enrollment ID: O20080930000036 |
| 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 | Derussy Emergency Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306300900 PECOS PAC ID: 3870834641 Enrollment ID: O20190403002252 |
| Entity Name | Hodges Emergency Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710441316 PECOS PAC ID: 2567703978 Enrollment ID: O20190412000898 |
| Entity Name | Clhg-leesville |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881665164 PECOS PAC ID: 4082963301 Enrollment ID: O20200310000179 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gary Lane Wease, MD 1020 W Fertitta Blvd, Leesville, LA 71446-4645 Ph: (337) 419-0735 | Dr Gary Lane Wease, MD 201 S. Arkansas Street, Leesville, LA 71446 Ph: (337) 239-7227 |