| Desoto Hospital Association | |
|
207 Jefferson St Mansfield LA 71052-2603 | |
| (318) 872-4610 | |
| (318) 872-1502 |
| Full Name | Desoto Hospital Association |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 207 Jefferson St, Mansfield, Louisiana |
| Authorized Official Name and Position | Todd Eppler (CEO) |
| Authorized Official Contact | 3188724610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desoto Hospital Association 207 Jefferson St Mansfield LA 71052-2603 Ph: (318) 872-4610 | Desoto Hospital Association 207 Jefferson St Mansfield LA 71052-2603 Ph: (318) 872-4610 |
| NPI Number | 1467455154 |
|---|---|
| Provider Enumeration Date | 05/27/2005 |
| Last Update Date | 07/09/2021 |
| Certification Date | 07/09/2021 |
| Medicare PECOS PAC ID | 2163321829 |
|---|---|
| Medicare Enrollment ID | O20040102000229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467455154 | NPI | - | NPPES |
| 1743283 | Medicaid | LA | |
| 04700 | Other | BLUE CROSS | |
| 119678402 | Medicaid | TX | |
| 1750131 | Medicaid | LA | |
| 90118 | Other | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 282N00000X | General Acute Care Hospital | 229 (Louisiana) | Primary |
| Provider Name | Richa Dhawan |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1194921718 PECOS PAC ID: 9234043886 Enrollment ID: I20031118000146 |
| Provider Name | Manash K Sarcar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346297553 PECOS PAC ID: 8729986849 Enrollment ID: I20031229000421 |
| Provider Name | Benjamin L Leggio |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851370332 PECOS PAC ID: 6507769916 Enrollment ID: I20040131000125 |
| Provider Name | James Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003808569 PECOS PAC ID: 0446141766 Enrollment ID: I20040324000479 |
| Provider Name | Lori Eubanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982717716 PECOS PAC ID: 9931192713 Enrollment ID: I20040407000142 |
| Provider Name | Chi Tai P Lau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750340592 PECOS PAC ID: 9931167509 Enrollment ID: I20050311000626 |
| Provider Name | William S Whyte |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1821060476 PECOS PAC ID: 1759289713 Enrollment ID: I20050502000056 |
| Provider Name | Vesela T Tzoneva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356436794 PECOS PAC ID: 4385641372 Enrollment ID: I20061106000192 |
| Provider Name | David M Abdehou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568471993 PECOS PAC ID: 7810094265 Enrollment ID: I20070518000213 |
| Provider Name | Douglas Matthew Casey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942498613 PECOS PAC ID: 3870674914 Enrollment ID: I20080115000623 |
| Provider Name | Brenton W Mcdonald |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528094455 PECOS PAC ID: 1254417132 Enrollment ID: I20080319000043 |
| Provider Name | Melissa Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790750362 PECOS PAC ID: 3274603329 Enrollment ID: I20080602000798 |
| Provider Name | William M Wilder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730120312 PECOS PAC ID: 6406872134 Enrollment ID: I20090520000335 |
| Provider Name | Marcus V Stelly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225206212 PECOS PAC ID: 1759412554 Enrollment ID: I20100623000074 |
| Provider Name | Chad T Porter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669652665 PECOS PAC ID: 0547391229 Enrollment ID: I20100624000002 |
| Provider Name | Gary V Burton |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1316968761 PECOS PAC ID: 8426172107 Enrollment ID: I20100901000936 |
| Provider Name | Brett R Travis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700082682 PECOS PAC ID: 5698917086 Enrollment ID: I20130814000856 |
| Provider Name | Ralph L Abraham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639346174 PECOS PAC ID: 2365686391 Enrollment ID: I20130913000109 |
| Provider Name | Stacey Leanne Dillard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710250204 PECOS PAC ID: 2365690864 Enrollment ID: I20131203001563 |
| Provider Name | Morgan Cheatham Haile |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760655500 PECOS PAC ID: 6901060292 Enrollment ID: I20140127001269 |
| Provider Name | Justin Pham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821040866 PECOS PAC ID: 0042104754 Enrollment ID: I20141022000483 |
| Provider Name | Matthew K Dang |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1588848857 PECOS PAC ID: 7517131147 Enrollment ID: I20150130000807 |
| Provider Name | Jessica D Caraway |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1710120274 PECOS PAC ID: 6103130463 Enrollment ID: I20150730011487 |
| Provider Name | Lowery R Reiland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487884730 PECOS PAC ID: 1951525484 Enrollment ID: I20151105001497 |
| Provider Name | Brian Sterling Dupree |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275780447 PECOS PAC ID: 1759684442 Enrollment ID: I20160130000116 |
| Provider Name | Anand M Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821433103 PECOS PAC ID: 7911205174 Enrollment ID: I20160620000756 |
| Provider Name | Caleb Blair Harkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053762146 PECOS PAC ID: 5294028205 Enrollment ID: I20160728002067 |
| Provider Name | Kimberly A Rials |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861841884 PECOS PAC ID: 5395033088 Enrollment ID: I20161012002142 |
| Provider Name | Angela Christine Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942650429 PECOS PAC ID: 7517250020 Enrollment ID: I20170425000658 |
| Provider Name | Larry D Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942660287 PECOS PAC ID: 4082987334 Enrollment ID: I20170907002321 |
| Provider Name | Claire A Bradley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396905477 PECOS PAC ID: 0840564738 Enrollment ID: I20170915000899 |
| Provider Name | Brandon Javier Salgado |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710243340 PECOS PAC ID: 8820301898 Enrollment ID: I20180907001543 |
| Provider Name | Naishia L Pipkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881943637 PECOS PAC ID: 6103129101 Enrollment ID: I20180924000335 |
| Provider Name | Jason Patrick Calligas |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1700102449 PECOS PAC ID: 2769767573 Enrollment ID: I20190826003155 |
| Provider Name | Vikram Mysore Hatti |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447202460 PECOS PAC ID: 3476554783 Enrollment ID: I20191007003390 |
| Provider Name | Poornima Ramadas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225442254 PECOS PAC ID: 8022355403 Enrollment ID: I20200624001816 |
| Provider Name | Michael Herron |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700867207 PECOS PAC ID: 1052362001 Enrollment ID: I20200918000383 |
| Provider Name | Jacqueline Loche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205434768 PECOS PAC ID: 2769892090 Enrollment ID: I20201028000072 |
| Provider Name | Stephen Johnston |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730525841 PECOS PAC ID: 0042574048 Enrollment ID: I20220307000090 |
| Provider Name | Michael Rolen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730316118 PECOS PAC ID: 8022330893 Enrollment ID: I20220819001219 |
| Provider Name | Sameh Sakla |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518250307 PECOS PAC ID: 5294080230 Enrollment ID: I20220824003695 |
| Provider Name | Nicholas Kramer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780118026 PECOS PAC ID: 1850767542 Enrollment ID: I20221020002678 |
| Provider Name | Caleb Ruben Rivera |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164410916 PECOS PAC ID: 5496791857 Enrollment ID: I20240308002322 |
| Provider Name | Rolando Ernesto Prieto |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578551321 PECOS PAC ID: 7416993860 Enrollment ID: I20240312001116 |
| Provider Name | Mikki Marie Olsson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144994146 PECOS PAC ID: 2062850407 Enrollment ID: I20240404002607 |
| Provider Name | Ryan Keith Tompkins |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619064623 PECOS PAC ID: 1052493152 Enrollment ID: I20240416002479 |
| Provider Name | Ronald Winters |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437593779 PECOS PAC ID: 8123382397 Enrollment ID: I20240503001227 |
| Provider Name | Matthew Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275869729 PECOS PAC ID: 6103148127 Enrollment ID: I20240513000864 |
| Provider Name | Jennifer Benjamin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255473310 PECOS PAC ID: 6305831264 Enrollment ID: I20241113004288 |
| Provider Name | Sarah Flanagan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760988067 PECOS PAC ID: 0749524353 Enrollment ID: I20250205003043 |
Department Of Health & Hospitals Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Louisiana Avenue, Mansfield, LA 71052 Phone: 318-872-5576 Fax: 318-872-9780 | |
Mansfield Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Louisiana St, Mansfield, LA 71052 Phone: 318-872-5576 | |
Outreach Family Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 Washington Ave, Mansfield, LA 71052 Phone: 318-872-0262 | |
Desoto Hospital Association Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 Jefferson St, Mansfield, LA 71052 Phone: 318-872-4610 Fax: 318-872-1502 | |
Cognitive Institute Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 Polk St, Mansfield, LA 71052 Phone: 318-871-5566 Fax: 318-871-1076 | |
Volunteers Of America Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1915 Mcarthur Dr, Mansfield, LA 71052 Phone: 318-872-1772 |