| Jose Kiamco Mendoza Jr, MD | |
|
4502 Highway 951, Jackson, LA 70748-5103 | |
| (225) 634-4820 | |
| (225) 634-0489 |
| Full Name | Jose Kiamco Mendoza Jr |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 4502 Highway 951, Jackson, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891796058 | NPI | - | NPPES |
| 1497371 | Medicaid | LA | |
| 0542328 | Medicaid | MS | |
| P00020217 | Other | LA | RAIL ROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | 023159 (Louisiana) | Secondary |
| 207R00000X | Internal Medicine | 023159 (Louisiana) | Primary |
| Entity Name | East Louisiana State Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043206543 PECOS PAC ID: 6002853835 Enrollment ID: O20050413000902 |
| Mailing Address | Practice Location Address |
|---|---|
| Jose Kiamco Mendoza Jr, MD 4502 Highway 951, Jackson, LA 70748-5103 Ph: (225) 634-4820 | Jose Kiamco Mendoza Jr, MD 4502 Highway 951, Jackson, LA 70748-5103 Ph: (225) 634-4820 |
Dr. Patrick G Mccrossen, DDS MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 4502 Louisiana Hwy 951, Jackson, LA 70748 Phone: 225-634-0413 | |
Dr. Gabriel I Onor Sr., MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 4502 Highway 951, Eastern La Mental Health System, Jackson, LA 70748 Phone: 225-634-0224 Fax: 225-634-0213 | |
Dr. Alan Ray Perego, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 4502 Highway 951, Jackson, LA 70748 Phone: 225-634-0341 Fax: 225-634-4464 | |
Nnamdi Andrew Nwabueze, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3050 Charles Dr, Jackson, LA 70748 Phone: 225-634-3517 |