| Mid State Orthopaedic & Sports Medicine Center, Llc | |
|
3444 Masonic Drive, Alexandria, LA 71301 | |
| (318) 473-9556 | |
| (318) 441-8339 |
| Full Name | Mid State Orthopaedic & Sports Medicine Center, Llc |
|---|---|
| Type | Facility |
| Speciality | Orthopaedic Surgery |
| Location | 3444 Masonic Drive, Alexandria, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104890052 | NPI | - | NPPES |
| 0570570001 | Other | LA | MEDICARE DME GROUP # |
| CD7720 | Other | LA | RAILROAD MEDICARE PALMETT |
| 1946320 | Medicaid | LA |
| Provider Name | Jeffrey L Garrison |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104849009 PECOS PAC ID: 7618916107 Enrollment ID: I20050425000882 |
| Provider Name | George H Lacour |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477599645 PECOS PAC ID: 7416960661 Enrollment ID: I20060711000305 |
| Provider Name | Daniel R Oas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093782443 PECOS PAC ID: 6305845207 Enrollment ID: I20071217000868 |
| Provider Name | Michael J Leddy |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1821052028 PECOS PAC ID: 0648351940 Enrollment ID: I20080111000695 |
| Provider Name | William D Crenshaw |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700099538 PECOS PAC ID: 2567516446 Enrollment ID: I20090811000618 |
| Provider Name | Rebecca L Smilie |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669775805 PECOS PAC ID: 0547441271 Enrollment ID: I20110228000853 |
| Provider Name | Jeanne S Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740694793 PECOS PAC ID: 1658599022 Enrollment ID: I20140826002577 |
| Provider Name | Timmothy Randell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1245460013 PECOS PAC ID: 9133345564 Enrollment ID: I20150811004279 |
| Provider Name | William D Rogenmoser |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1902171176 PECOS PAC ID: 6800186693 Enrollment ID: I20160607001821 |
| Provider Name | Jamie L Rister |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1770801763 PECOS PAC ID: 0749426617 Enrollment ID: I20160722001386 |
| Provider Name | Janssen S Meeker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417409996 PECOS PAC ID: 6204116197 Enrollment ID: I20161212001100 |
| Provider Name | James A Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568901874 PECOS PAC ID: 6204174139 Enrollment ID: I20190219000585 |
| Provider Name | Amy L Stallings |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871151399 PECOS PAC ID: 9739415795 Enrollment ID: I20190729002104 |
| Provider Name | Abby L Fennell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740887694 PECOS PAC ID: 8820409196 Enrollment ID: I20201118001961 |
| Provider Name | Larry J Doughty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922549211 PECOS PAC ID: 2365714177 Enrollment ID: I20220707000431 |
| Provider Name | Mandy R Guilliams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578291258 PECOS PAC ID: 2668847138 Enrollment ID: I20230414000928 |
| Provider Name | Miles S Parsons |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407385586 PECOS PAC ID: 7517230212 Enrollment ID: I20230821003184 |
| Provider Name | Rashad J Sullivan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174962856 PECOS PAC ID: 0042511974 Enrollment ID: I20250116001353 |
| Provider Name | Klaire E Sutton |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336950583 PECOS PAC ID: 0840729315 Enrollment ID: I20250128004980 |
| Mailing Address | Practice Location Address |
|---|---|
| Mid State Orthopaedic & Sports Medicine Center, Llc 3444 Masonic Drive, Alexandria, LA 71301 Ph: (318) 473-9556 | Mid State Orthopaedic & Sports Medicine Center, Llc 3444 Masonic Drive, Alexandria, LA 71301 Ph: (318) 473-9556 |