| Bossier Family Medicine | |
|
2539 Viking Dr Ste 101 Bossier City LA 71111-2165 | |
| (318) 747-8100 | |
| (318) 747-8151 |
| Full Name | Bossier Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 2539 Viking Dr Ste 101, Bossier City, Louisiana |
| Authorized Official Name and Position | Sandy Spears (CREDENTIALING MANAGER) |
| Authorized Official Contact | 3189253338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bossier Family Medicine 2539 Viking Dr Ste 101 Bossier City LA 71111-2165 Ph: (318) 747-8100 | Bossier Family Medicine 2539 Viking Dr Ste 101 Bossier City LA 71111-2165 Ph: (318) 747-8100 |
| NPI Number | 1003032236 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 10/29/2020 |
| Medicare PECOS PAC ID | 1850318122 |
|---|---|
| Medicare Enrollment ID | O20051026000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003032236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Patrick Deere |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477526275 PECOS PAC ID: 5496715948 Enrollment ID: I20041019000174 |
| Provider Name | William F Maranto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124016985 PECOS PAC ID: 7810941176 Enrollment ID: I20050309000584 |
| Provider Name | Basil Scott Harrington |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841229358 PECOS PAC ID: 3072612290 Enrollment ID: I20070628000137 |
| Provider Name | Robert K Saucier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659369411 PECOS PAC ID: 8325129034 Enrollment ID: I20111026000428 |
| Provider Name | Chesney Marie Finley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225588312 PECOS PAC ID: 1456632702 Enrollment ID: I20161229000965 |
| Provider Name | Jennifer C O'neal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275929929 PECOS PAC ID: 5193004018 Enrollment ID: I20180829002583 |
| Provider Name | Chelsea Colvin Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417443672 PECOS PAC ID: 3173873866 Enrollment ID: I20180829003814 |
| Provider Name | Ursula Maroski Carlisle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770083909 PECOS PAC ID: 1557611258 Enrollment ID: I20180829004257 |
| Provider Name | Sheri M Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437615069 PECOS PAC ID: 7810239548 Enrollment ID: I20190430001186 |
| Provider Name | Hannah Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558923979 PECOS PAC ID: 7719307321 Enrollment ID: I20201021000933 |
| Provider Name | Leisa Joan Roan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568078392 PECOS PAC ID: 5991108367 Enrollment ID: I20210722000921 |
| Provider Name | Amanda Beshea Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598331464 PECOS PAC ID: 2860897253 Enrollment ID: I20210824000466 |
| Provider Name | Stephen Craig Mccann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184750044 PECOS PAC ID: 8628468873 Enrollment ID: I20211202002724 |
| Provider Name | Candice Marie Midkiff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154054492 PECOS PAC ID: 8729462049 Enrollment ID: I20220905000094 |
| Provider Name | Patrick St. Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326676511 PECOS PAC ID: 4284007964 Enrollment ID: I20230228000403 |
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