| Ivan A Villalta-wehmeyer, MD | |
| 
					15790 Paul Vega Md, Dr, Hammond, LA 70403  | |
| (985) 230-6900 | |
| (985) 230-6531 | 
| Full Name | Ivan A Villalta-wehmeyer | 
|---|---|
| Gender | Male | 
| Speciality | Pediatrics - Neonatal-perinatal Medicine | 
| Location | 15790 Paul Vega Md, Dr, Hammond, Louisiana | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1932278181 | NPI | - | NPPES | 
| 1392995 | Medicaid | LA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2080N0001X | Pediatrics - Neonatal-perinatal Medicine | 01032685A (Indiana) | Secondary | 
| 2080N0001X | Pediatrics - Neonatal-perinatal Medicine | MD06771R (Louisiana) | Primary | 
| Entity Name | Southeastern Intensivist Services Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1912942665 PECOS PAC ID: 9335152107 Enrollment ID: O20190131001122  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ivan A Villalta-wehmeyer, MD 39359 Bay Dr, Ponchatoula, LA 70454-6657 Ph: (985) 230-6900  | Ivan A Villalta-wehmeyer, MD 15790 Paul Vega Md, Dr, Hammond, LA 70403 Ph: (985) 230-6900  | 
Dr. Gina Payton Lagarde, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 15481 W Club Deluxe Rd, Hammond, LA 70403 Phone: 985-543-4880 Fax: 985-543-4888  | |
Dr. Christopher Leumas, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 42440 Pelican Professional Park, Hammond, LA 70403 Phone: 985-542-4950 Fax: 985-542-6089  | |
Dr. Roger Rholdon Sr., M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 42440 Pelican Professional Park, Hammond, LA 70403 Phone: 985-542-4950 Fax: 985-542-6089  | |
Dr. Samuel Hickey Jr., M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 42440 Pelican Professional Park, Hammond, LA 70403 Phone: 985-542-4950 Fax: 985-542-6089  | |
Abbey Lewis Gallien, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 42124 Veterans Ave, Suite A, Hammond, LA 70403 Phone: 985-543-0565 Fax: 985-543-0567  | |
Elizabeth Hazard Fritz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 42440 Pelican Professional Park, Hammond, LA 70403 Phone: 985-542-4950 Fax: 985-542-6089  | |
Dr. Leo Westmoreland Jr., M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 42440 Pelican Professional Park, Hammond, LA 70403 Phone: 985-542-4950 Fax: 985-542-6089  |