| Lsmd Medical Llc | |
|
1516 Chemin Metairie Rd Youngsville LA 70592-2000 | |
| (337) 351-5510 | |
| Not Available |
| Full Name | Lsmd Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1516 Chemin Metairie Rd, Youngsville, Louisiana |
| Authorized Official Name and Position | Tonia L Sylvester (CLINICAL COORDINATOR) |
| Authorized Official Contact | 3373515510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lsmd Medical Llc 107 Milton Estates Ln Youngsville LA 70592-6090 Ph: (337) 351-5510 | Lsmd Medical Llc 1516 Chemin Metairie Rd Youngsville LA 70592-2000 Ph: (337) 351-5510 |
| NPI Number | 1720623010 |
|---|---|
| Provider Enumeration Date | 11/11/2019 |
| Last Update Date | 04/13/2020 |
| Medicare PECOS PAC ID | 9931537305 |
|---|---|
| Medicare Enrollment ID | O20200318000564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720623010 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Primary |
| Provider Name | Mark J Landry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679518823 PECOS PAC ID: 0941253504 Enrollment ID: I20050224000661 |
| Provider Name | Jessica L Landry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508975111 PECOS PAC ID: 0941259527 Enrollment ID: I20050415000756 |
| Provider Name | William Mask |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215030507 PECOS PAC ID: 2264452457 Enrollment ID: I20080722000445 |
| Provider Name | Kristin Elizabeth Tauzin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093053522 PECOS PAC ID: 3375789597 Enrollment ID: I20130413000006 |
| Provider Name | Lauren Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902212301 PECOS PAC ID: 7012133010 Enrollment ID: I20140729000381 |
| Provider Name | John B Imms |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114366812 PECOS PAC ID: 0840579975 Enrollment ID: I20161114001307 |
| Provider Name | Donna Boudreaux Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982196432 PECOS PAC ID: 0648524017 Enrollment ID: I20181121002015 |
| Provider Name | Nicole M Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245829407 PECOS PAC ID: 6800203878 Enrollment ID: I20210319000315 |
| Provider Name | Patrice Leblanc Hebert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447827340 PECOS PAC ID: 9032512462 Enrollment ID: I20210722003493 |
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