| Woman's Specialty Clinic | |
|
500 Rue De La Vie St Suite 515 Baton Rouge LA 70817-5127 | |
| (225) 924-8550 | |
| (225) 924-8647 |
| Full Name | Woman's Specialty Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 Rue De La Vie St, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Teri G Fontenot (CEO AND PRESIDENT) |
| Authorized Official Contact | 2259271300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woman's Specialty Clinic 500 Rue De La Vie St Ste 311 Baton Rouge LA 70817-5128 Ph: (225) 924-8550 | Woman's Specialty Clinic 500 Rue De La Vie St Suite 515 Baton Rouge LA 70817-5127 Ph: (225) 924-8550 |
| NPI Number | 1366483315 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 08/19/2022 |
| Medicare PECOS PAC ID | 8921903048 |
|---|---|
| Medicare Enrollment ID | O20031203000149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366483315 | NPI | - | NPPES |
| 1444677 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Duane D Superneau |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427018274 PECOS PAC ID: 0143125195 Enrollment ID: I20031203000283 |
| Provider Name | Charles L Pearson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1801806153 PECOS PAC ID: 5294622163 Enrollment ID: I20040304000049 |
| Provider Name | Stuart J Lebas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073518510 PECOS PAC ID: 7012010036 Enrollment ID: I20070410000317 |
| Provider Name | Beverly Ogden |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1326008210 PECOS PAC ID: 0042240376 Enrollment ID: I20080617000616 |
| Provider Name | Robert L Koscick |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1508826348 PECOS PAC ID: 6305876632 Enrollment ID: I20100603000966 |
| Provider Name | Barry G Hallner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508030958 PECOS PAC ID: 6406011048 Enrollment ID: I20120703000546 |
| Provider Name | Armanda D. Tatsas |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1134276926 PECOS PAC ID: 6800065293 Enrollment ID: I20130719000021 |
| Provider Name | Amberly L Nunez |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1265693535 PECOS PAC ID: 9335385053 Enrollment ID: I20130719000063 |
| Provider Name | Jonathan Curtis Stone |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1225272578 PECOS PAC ID: 3870716434 Enrollment ID: I20140529000529 |
| Provider Name | Zarius Drummond |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1093733412 PECOS PAC ID: 7810990181 Enrollment ID: I20141017000095 |
| Provider Name | Amanda Lee Gorena |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1356501290 PECOS PAC ID: 6002131570 Enrollment ID: I20150205000576 |
| Provider Name | Abdulla Majid-moosa |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1558628859 PECOS PAC ID: 5496997330 Enrollment ID: I20180807001015 |
| Provider Name | David Neil Campbell |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1134562432 PECOS PAC ID: 4981844750 Enrollment ID: I20190731001522 |
| Provider Name | Yash D Shah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487107074 PECOS PAC ID: 7618378266 Enrollment ID: I20220525001076 |
| Provider Name | Jocelyn Bailosis Lorenzo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265883375 PECOS PAC ID: 9739472127 Enrollment ID: I20220609001838 |
| Provider Name | Chad Mcnair Manuel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861924284 PECOS PAC ID: 9234506213 Enrollment ID: I20230512000008 |
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