MANLEY MCRAE JORDAN (NPI# 1932118296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932118296 |
| Entity Type | Individual |
| Full Name | MANLEY MCRAE JORDAN |
| Credential | MD |
| Practice Address |
2770 3rd Ave Suite 110 Lake Charles LA 70601-8994 |
| Mailing Address |
Po Box 122309 Dept 2309 Dallas TX 75312-2309 |
| Practice Telephone | 3374942750 |
| Practice Fax Number | 3374942760 |
| Mailing Telephone | 3374942919 |
| Mailing Fax Number | 3374943069 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2015-12-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
017837 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | RAILROAD MEDICARE | P00221352 | 01 |
| LA | 1468444 | 05 |
| Street Address |
2770 3RD AVE SUITE 110 |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70601-8994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831189174 | Cynthia G Cox | Nurse Practitioner | 2770 3rd Ave, Suite 225, Lake Charles, LA 70601-8994 | 2005-10-27 |
| 1437692605 | Amanda Paige Mulig | Nurse Practitioner | 2770 3rd Ave, Ste 120, Lake Charles, LA 70601-8994 | 2016-11-21 |
| 1356607659 | Jason Kent Langhofer | Internal Medicine | 2770 3rd Ave, Ste 350, Lake Charles, LA 70601-8994 | 2012-04-11 |
| 1982960373 | Craig Alan Greenman | Internal Medicine | 2770 3rd Ave, Ste 350, Lake Charles, LA 70601-8994 | 2012-04-10 |
| 1407168032 | Lcms Surgical Associates of Southwest Lousiana, LLC | Surgery | 2770 3rd Ave, Suite 120, Lake Charles, LA 70601-8994 | 2010-07-12 |
| 1942461207 | Clifford Armand Courville | Internal Medicine | 2770 3rd Ave, Ste 110, Lake Charles, LA 70601-8994 | 2008-06-19 |
| 1245414481 | Endocrinology Center of Southwest La LLC | Specialist | 2770 3rd Ave, Suite 345, Lake Charles, LA 70601-8994 | 2007-12-24 |
| 1790803278 | Mary Beth Neeley | Nurse Practitioner | 2770 3rd Ave, Suite 350 Lake Charles Memorial Hospital Internal Medic, Lake Charles, LA 70601 | 2007-03-26 |
| 1093849515 | Floyd Anthony Gaspard Jr. | Registered Nurse | 2770 3rd Ave, Suite 225, Lake Charles, LA 70601 | 2007-03-15 |
| 1427181908 | Mark D Lafuria | Internal Medicine | 2770 3rd Ave, Suite 350, Lake Charles, LA 70601-8994 | 2007-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833872 | Fresenius Medical Care Sulphur, LLC | Clinic/Center | 330 Chavanne Street, Lake Charles, LA 70601 | 2020-08-24 |
| 1174158844 | Andrea Cormier | Peer Specialist | 751 E Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2020-03-03 |
| 1588297303 | Vivian Claire Miller Monceaux | Chiropractor | 780 Bayou Pines East Drive, Lake Charles, LA 70601 | 2020-02-20 |
| 1568001014 | Swla Center for Health Services | Clinic/Center | 3820 Senator J. Bennett Johnston Ave, Charleston Bldg 8, Lake Charles, LA 70601 | 2020-01-02 |
| 1417512070 | Ryan Nathaniel Vaisler | Student in an Organized Health Care Education/Training Program | 1525 Oak Park Blvd., Lake Charles, LA 70601 | 2019-05-08 |
| 1336600675 | Hoh Palliative Care, LLC | Family Medicine | 750 East Bayou Pines, Suite A, Lake Charles, LA 70601 | 2019-03-28 |
| 1073079026 | Alawrass LLC | Pharmacy | 803 E Prien Lake Rd, Lake Charles, LA 70601 | 2019-02-14 |
| 1861962722 | Ellaweena Woods | Counselor | 1409 Kirkman St., Lake Charles, LA 70601 | 2018-12-04 |
| 1770051963 | Hanna Marie Rodriguez | Counselor | 751 Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2018-11-06 |
| 1023585213 | Shandora Druilhet | Case Manager/Care Coordinator | 751 E Bayou Pines, Lake Charles, LA 70601 | 2018-10-26 |
| Find all providers in zip 70601 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912989443 | Janardana P. Kaimal | Internal Medicine | 4820 Lake St, Suite 2, Lake Charles, LA 70605-6010 | 2005-11-18 |
| 1508175704 | Lcms Pulmonary Associates of Southwest Louisiana | Internal Medicine | 2770 3rd Ave Ste 350, Lake Charles, LA 70601-0404 | 2010-10-05 |
| 1942461207 | Clifford Armand Courville | Internal Medicine | 2770 3rd Ave, Ste 110, Lake Charles, LA 70601-8994 | 2008-06-19 |
| 1821007170 | Robert Craig Broussard | Internal Medicine | 2770 3rd Ave, Suite 110, Lake Charles, LA 70601-8994 | 2006-08-05 |
| 1710996079 | Ben Frank Thompson IIi | Internal Medicine | 2770 3rd Ave, Suite 110, Lake Charles, LA 70601-8994 | 2006-08-05 |
| 1881603140 | Gary Jules Kohler | Internal Medicine | 2770 3rd Ave, Suite 110, Lake Charles, LA 70601-8994 | 2006-08-05 |
| 1154335958 | Lake Charles Medical Services Inc | Internal Medicine | 2770 3rd Ave, Suite 110, Lake Charles, LA 70601-8994 | 2006-07-28 |
| 1659347854 | Luke M Williams | Internal Medicine | 501 Dr Michael Debakey Dr, Lake Charles, LA 70601-5724 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487997219 | Ramsy Assaf Abdelghani | Internal Medicine | 1415 Tulane Ave Fl 7, New Orleans, LA 70112-2600 | 2013-03-29 |
| 1770823098 | Emergency and Critical Care Services LLC | Internal Medicine | 8965 Highway 79, Greenwood, LA 71033-2721 | 2013-02-22 |
| 1104161843 | Christus Health and Lunn Pulmonology | Internal Medicine | 1455 E. Bert Kouns, Suite #202, Christus Health and Lunn Pulmonology, Shreveport, LA 71105 | 2012-12-06 |
| 1770872616 | Gbr, LLC | Internal Medicine | 155 Hospital Dr. Ste 101, Lafayette, LA 70503 | 2011-03-31 |
| 1992016133 | Andrea Rudomin Conant Lorio | Internal Medicine | 8120 Main Street, Suite 204, Houma, LA 70360 | 2010-06-22 |
| 1326208232 | Brian Jude Parker | Internal Medicine | 604 N Acadia Rd Ste 411, Thibodaux, LA 70301 | 2008-06-13 |
| 1841463114 | David Yoshi Patten | Internal Medicine | 3872 S Inwood Ave, New Orleans, LA 70131 | 2008-04-08 |
| 1750401022 | Richard C Hebert | Internal Medicine | 6267 Sevenoaks Ave, Baton Rouge, LA 70806-7301 | 2007-03-30 |
| 1982765947 | Roger Edmund Stueben | Internal Medicine | 1107 Audubon Ave, Suite B, Thibodaux, LA 70301 | 2006-12-13 |
| 1962593798 | Physicians of Sleep Associates LLC | Internal Medicine | 5246 Brittany Dr, Baton Rouge, LA 70808-9136 | 2006-09-27 |
| Find all providers with the same taxonomy | ||||
| City | LAKE CHARLES |
| Zip Code | 70601 |
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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.