| Ralph Jonathan Henderson, MD | |
|
255 Bert Kouns, Shreveport, LA 71106 | |
| (318) 683-0411 | |
| (318) 603-5461 |
| Full Name | Ralph Jonathan Henderson |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 35 Years |
| Location | 255 Bert Kouns, Shreveport, 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 |
|---|---|---|---|
| 1164427621 | NPI | - | NPPES |
| 1924075 | Medicaid | LA | |
| 340019771 | Other | LA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 021340 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Baptist Health Medical Center-little Rock | Little rock, AR | Hospital |
| Chi-st Vincent Infirmary | Little rock, AR | Hospital |
| Baptist Health Medical Center North Little Rock | North little rock, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Arkansas Urology, P.a. | 4082502547 | 32 |
| Entity Name | Arkansas Urology, P.a. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093720443 PECOS PAC ID: 4082502547 Enrollment ID: O20040306000102 |
| Mailing Address | Practice Location Address |
|---|---|
| Ralph Jonathan Henderson, MD 255 Bert Kouns Loop, Shreveport, LA 71106-8150 Ph: (318) 683-0411 | Ralph Jonathan Henderson, MD 255 Bert Kouns, Shreveport, LA 71106 Ph: (318) 683-0411 |
Dennis Dale Venable, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 1501 Kings Hwy, Department Of Urology, Shreveport, LA 71103 Phone: 318-813-2750 Fax: 318-813-2755 | |
Alison Smith Spann, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 255 Bert Kouns Industrial Loop, Shreveport, LA 71106 Phone: 318-683-0411 Fax: 318-688-8525 | |
Raymond Wendell Turner, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 9854 Jennifer Ln, Shreveport, LA 71106 Phone: 318-797-5786 | |
Dr. Tajammul N Fazili, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 510 E Stoner Ave, Shreveport, LA 71101 Phone: 318-221-8411 | |
Mrs. Ashley Sittig Baker, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 255 Bert Kouns, Shreveport, LA 71106 Phone: 318-683-0411 Fax: 318-603-5461 | |
Andre Paul Broussard, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1501 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-5053 |