| Dr. K's Family Medicine | |
|
2781 S Columbia St Suite A Bogalusa LA 70427-7962 | |
| (229) 869-0294 | |
| Not Available |
| Full Name | Dr. K's Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 2781 S Columbia St, Bogalusa, Louisiana |
| Authorized Official Name and Position | Keisha Harvey (PRESIDENT) |
| Authorized Official Contact | 2298290294 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. K's Family Medicine 2871 S. Columbia St Ste A Bogalusa LA 70427 | Dr. K's Family Medicine 2781 S Columbia St Suite A Bogalusa LA 70427-7962 Ph: (229) 869-0294 |
| NPI Number | 1265971147 |
|---|---|
| Provider Enumeration Date | 02/13/2017 |
| Last Update Date | 07/12/2023 |
| Certification Date | 07/12/2023 |
| Medicare PECOS PAC ID | 9335426121 |
|---|---|
| Medicare Enrollment ID | O20170504000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265971147 | NPI | - | NPPES |
| MD206754 | Other | LSBME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| Provider Name | Keisha D Harvey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821355637 PECOS PAC ID: 5597980631 Enrollment ID: I20140707000328 |
| Provider Name | Alvin G Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083138226 PECOS PAC ID: 9739446261 Enrollment ID: I20171207002769 |
| Provider Name | Kristin Diondre Lynch Grimes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558603563 PECOS PAC ID: 2668773375 Enrollment ID: I20180221000734 |
| Provider Name | Thomandra Shavaun Sam |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477850667 PECOS PAC ID: 2860864618 Enrollment ID: I20230204000522 |
| Provider Name | Vincentoria Powell Conley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215815998 PECOS PAC ID: 7911477989 Enrollment ID: I20260601000264 |
Bogalusa Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 M J Israel Dr, Bogalusa, LA 70427 Phone: 985-732-7122 |
Bogalusa Family Medicine & Behavioral Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 219 S Border Dr, Bogalusa, LA 70427 Phone: 985-732-1568 |
Bogalusa Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1403 North Ave, Bogalusa, LA 70427 Phone: 985-732-7122 |
Purnachandra R Yerneni MD Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Avenue F, Bogalusa, LA 70427 Phone: 985-732-9930 Fax: 985-732-9884 |
Rogelio A. Casama, MD, APMC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2807 S Columbia St, Bogalusa, LA 70427 Phone: 985-735-8382 Fax: 985-735-9075 |
Bogalusa Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 433 Plaza St, Bogalusa, LA 70427 Phone: 985-735-1198 |