DR. LORETTA PYLANT GREMILLION (NPI# 1073704391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073704391 |
| Entity Type | Individual |
| Full Name | DR. LORETTA PYLANT GREMILLION |
| Credential | M.D. |
| Practice Address |
2409 Broadmoor Blvd Monroe LA 71201-2964 |
| Mailing Address |
1868 Forsythe Ave Ste 335 Monroe LA 71201-3540 |
| Practice Telephone | 3183238799 |
| Practice Fax Number | 3183238815 |
| Mailing Telephone | 3182516216 |
| Mailing Fax Number | 3182516257 |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2018-06-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 026501 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1059587 | 05 | |
| LA | MEDICARE | 4N1007387 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 South Farmerville Street, Ruston, LA 712705941 | 3182516216 | 3182516257 |
| Street Address |
2409 BROADMOOR BLVD |
| City | MONROE |
| State | LA |
| Zip Code | 71201-2964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336439553 | Advanced Dermatology Care A Professional Medical Corporation | Clinic/Center | 2409 Broadmoor Blvd, Monroe, LA 71201-2964 | 2011-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831035 | Tammy Price | Social Worker | 414 Pine Street, Monroe, LA 71201 | 2020-04-30 |
| 1932749116 | Emmanuel Brown Jr. | Case Manager/Care Coordinator | 2808 Evangeline Street, Monroe, LA 71201 | 2020-01-15 |
| 1063050961 | James J Gregory | Social Worker | 4800 S Grand, Monroe, LA 71201 | 2019-12-11 |
| 1285271221 | William Fairley | Non-emergency Medical Transport (VAN) | 1002 N. 7th St., Apt. 4, Monroe, LA 71201 | 2019-12-10 |
| 1619431715 | Guidance Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 1204 Stubbs Ave. Suite B, Monroe, LA 71201 | 2019-01-23 |
| 1184193286 | Marnesha Davis | Assistant Behavior Analyst | 500 N. 21st Street, Monroe, LA 71201 | 2018-11-19 |
| 1912476482 | Gbc Hope | Residential Treatment Facility, Emotionally Disturbed Children | 311 South 1st Street, Monroe, LA 71201 | 2018-11-14 |
| 1124502505 | Orthopaedic Clinic of Monroe | Non-Pharmacy Dispensing Site | 1501 Louisville Ave., Monroe, LA 71201 | 2018-09-20 |
| 1699266643 | Melissa Anne De La O | Audiologist | 2516 Broadmoor Blvd # 1b, Monroe, LA 71201 | 2018-05-25 |
| 1588153738 | Essential Family Medicine, LLC | Nurse Practitioner | 2014 Tower Dr. Ste A, Monroe, LA 71201 | 2018-05-03 |
| Find all providers in zip 71201 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518223148 | Lauren Nibler Craddock | Dermatology | 412 18th Ave, Monroe, WI 53566 | 2012-04-09 |
| 1801061718 | James M. Ulery Jr Md PC | Dermatology | 1310 N Macomb St, Monroe, MI 48162-3131 | 2008-04-23 |
| 1972624120 | Leonid Izikson | Dermatology | 745 State Route 17m, Monroe, NY 10950-2660 | 2007-04-03 |
| 1366548885 | Creighton Chandler Jr. | Dermatology | 920 Oliver Rd # A, Monroe, LA 71201-5702 | 2006-09-15 |
| 1043313919 | James Martin Ulery Jr. | Dermatology | 315 Stewart Rd, Monroe, MI 48162-4393 | 2006-09-06 |
| 1851316590 | Janine O Hopkins | Dermatology | 2509 Broadmoor Blvd, Ste A, Monroe, LA 71201-2987 | 2006-07-13 |
| 1922062322 | James Arthur Altick Jr. | Dermatology | 2804 Kilpatrick Blvd, Monroe, LA 71201-5139 | 2006-04-13 |
| 1205454865 | Woundrite Physicians Management, LLC | Dermatology | 1971 N Monroe St, Monroe, MI 48162-4255 | 2020-07-10 |
| 1699300939 | Chronic Disease Management of Georgia, LLC | Dermatology | 704 Breedlove Dr Ste A, Monroe, GA 30655-2054 | 2020-03-06 |
| 1053957944 | Affinity Health Group LLC | Dermatology | 920 Oliver Rd # A, Monroe, LA 71201-5702 | 2019-11-26 |
| Find all providers in MONROE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.