| Jeffrey Tanita, MD | |
|
1136a N Pine Rd, Olla, LA 71465-4804 | |
| (318) 495-3880 | |
| (318) 495-3882 |
| Full Name | Jeffrey Tanita |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 24 Years |
| Location | 1136a N Pine Rd, Olla, 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 |
|---|---|---|---|
| 1922040443 | NPI | - | NPPES |
| 1449342 | Medicaid | LA | |
| 1054356 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 200484 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mount Grant General Hospital | Hawthorne, NV | Hospital |
| Klickitat Valley Hospital | Goldendale, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mt Grant General Hospital | 1951290337 | 13 |
| Entity Name | Mt Grant General Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801844527 PECOS PAC ID: 1951290337 Enrollment ID: O20040312001277 |
| Entity Name | Lincoln County Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659423341 PECOS PAC ID: 2163408246 Enrollment ID: O20040629000192 |
| 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 |