| South Louisiana Primary Care Llc | |
|
12902 Plank Rd Baker LA 70714-4911 | |
| (225) 218-4816 | |
| (225) 302-5057 |
| Full Name | South Louisiana Primary Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 12902 Plank Rd, Baker, Louisiana |
| Authorized Official Name and Position | Dustin Allen Logue (OWNER) |
| Authorized Official Contact | 2257740733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Louisiana Primary Care Llc 12902 Plank Rd Baker LA 70714-4911 Ph: (225) 774-0733 | South Louisiana Primary Care Llc 12902 Plank Rd Baker LA 70714-4911 Ph: (225) 218-4816 |
| NPI Number | 1447705074 |
|---|---|
| Provider Enumeration Date | 08/24/2016 |
| Last Update Date | 07/08/2024 |
| Medicare PECOS PAC ID | 7416245923 |
|---|---|
| Medicare Enrollment ID | O20161017002159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447705074 | NPI | - | NPPES |
| 2110691 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | AP06078 (Louisiana) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ernest G Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841212610 PECOS PAC ID: 3072692649 Enrollment ID: I20080507000424 |
| Provider Name | Dustin Logue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003146226 PECOS PAC ID: 2769513423 Enrollment ID: I20100624000938 |
| Provider Name | Hailey Mcmanus Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508414855 PECOS PAC ID: 7911372834 Enrollment ID: I20230406002285 |
| Provider Name | Megan Mccoy Dale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003596206 PECOS PAC ID: 8820515224 Enrollment ID: I20250508003148 |
Premier Wellness Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4444 Groom Rd, Baker, LA 70714 Phone: 225-774-9134 Fax: 225-774-9136 | |
Unique Healthcare Options Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5120 Groom Rd, Baker, LA 70714 Phone: 225-774-1077 Fax: 225-774-1078 | |
Ernest Gene Thompson Jr Md Apmc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12902 Plank Rd, Baker, LA 70714 Phone: 225-774-3883 Fax: 225-774-7777 | |
Mercy Primary Care Home Visits Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8519 Pettit Rd, Baker, LA 70714 Phone: 225-200-3216 | |
Mcms, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17625 Wisdom Dr, Baker, LA 70714 Phone: 225-505-5217 Fax: 225-658-0099 | |
Mark C Mouton Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12880 Plank Rd, Baker, LA 70714 Phone: 225-774-7111 Fax: 225-774-7714 |