| Peyton Rachal, | |
|
1501 Kings Hwy, Shreveport, LA 71103-4228 | |
| (318) 626-0008 | |
| (318) 675-7934 |
| Full Name | Peyton Rachal |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 1501 Kings Hwy, Shreveport, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902416738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 324558 (Louisiana) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Secondary |
| Entity Name | LSU Health Sciences Center Shreveport Faculty Group Practice |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013374222 PECOS PAC ID: 4082902721 Enrollment ID: O20161012000307 |
| Entity Name | University Health Shreveport, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619443611 PECOS PAC ID: 7416207196 Enrollment ID: O20181109000875 |
| Mailing Address | Practice Location Address |
|---|---|
| Peyton Rachal, 1501 Kings Hwy, Shreveport, LA 71103-4228 Ph: (318) 626-0008 | Peyton Rachal, 1501 Kings Hwy, Shreveport, LA 71103-4228 Ph: (318) 626-0008 |
Tate James Perque, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1453 E Bert Kouns Industrial Loop Ste 318, Shreveport, LA 71105 Phone: 318-681-1968 Fax: 318-681-1969 |
Jennifer B Cypher, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 |
Mrs. Kristi Harrison Gaspard, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 8383 Millicent Way, Shreveport, LA 71115 Phone: 318-797-6661 Fax: 318-795-8512 |
Susan Lenora Steen, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1501 Kings Hwy, Department Of Neurosurgery, Shreveport, LA 71103 Phone: 318-675-6901 Fax: 318-675-4819 |
Jeanette Catherine Pang, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 7925 Youree Dr Ste 200, Shreveport, LA 71105 Phone: 318-212-3610 Fax: 318-212-3709 |
Dakota Shayne Barlow, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1811 E Bert Kouns Industrial Loop Ste 210, Shreveport, LA 71105 Phone: 318-212-3858 Fax: 318-212-3958 |
Heather Vogel, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1501 Kings Hwy, Shreveport, LA 71103 Phone: 337-515-2538 |