| Jeffrey Tanita, MD | |
|
1136a N Pine Rd, Olla, LA 71465-4804 | |
| (318) 495-3880 | |
| (318) 495-3882 |
| Full Name | Jeffrey Tanita |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1136a N Pine Rd, Olla, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922040443 | NPI | - | NPPES |
| 1449342 | Medicaid | LA | |
| 1054356 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 200484 (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 | 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 | 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 | Vermilion Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215161096 PECOS PAC ID: 8820148554 Enrollment ID: O20090618000010 |
| Entity Name | Abbeville Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760799290 PECOS PAC ID: 3375731185 Enrollment ID: O20101221000525 |
| Entity Name | Evangeline Clinical Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235510280 PECOS PAC ID: 3870805104 Enrollment ID: O20160223000852 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey Tanita, MD 1136a N Pine Rd, Olla, LA 71465-4804 Ph: (318) 495-3880 | Jeffrey Tanita, MD 1136a N Pine Rd, Olla, LA 71465-4804 Ph: (318) 495-3880 |
Dr. Charl Frederick Du Toit Ceronio, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1102 N Pine Rd, Olla, LA 71465 Phone: 318-446-4534 | |
Tyler Kennedy Hinson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1049 N Pine Rd Ste C, Olla, LA 71465 Phone: 318-495-3131 | |
Dr. Wayne S Barksdale, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1049 N Pine Rd, Olla, LA 71465 Phone: 318-495-3175 Fax: 318-495-0750 |