DR. PHILIP A GARDNER (NPI# 1952375487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952375487 |
| Entity Type | Individual |
| Full Name | DR. PHILIP A GARDNER |
| Credential | MD |
| Practice Address |
1203 S Tyler St Suite B Covington LA 70433-2329 |
| Practice Telephone | 9858935958 |
| Practice Fax Number | 9858935902 |
| Mailing Telephone | 9858935958 |
| Mailing Fax Number | 9858935902 |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2016-07-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 03988R | LA | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
03988R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1319210 | 05 | |
| LA | MEDICAL LICENSE | 03988R | 01 |
| FEDERAL DEA REGISTRATION | BG8983303 | 01 | |
| LA | LA DHH CONTROLED SUBST | 8641 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265827356 | Philip Gardner | Otolaryngology | 7703 Floyd Curl Dr, San Antonio, TX 78229-3901 | 2015-04-06 |
| 1538467345 | Philip Edward Gardner | Social Worker | 1740 E 17th St, Idaho Falls, ID 83404-6375 | 2011-03-02 |
| 1790085736 | Philip A Gardner | Social Worker | 250 W 57th St, Suite 501, New York, NY 10107-0001 | 2010-10-25 |
| 1003076498 | Philip D Gardner Jr. | Counselor | 204 N Cayuga St, Ithaca, NY 14850-4333 | 2008-06-10 |
| 1558545251 | Philip B Gardner | Psychologist | 1315 Windrim Avenue, C/o Wes Health Systems, Philadelphia, PA 19141 | 2007-12-18 |
| 1235282252 | Philip Leo Gardner | Ophthalmology | 2241 Central Ave, Suite A, Alameda, CA 94501-4460 | 2007-01-21 |
| 1497865844 | Philip W Gardner | Dentist | 1234 E Dupont Rd, Ste 4, Fort Wayne, IN 46825 | 2006-08-30 |
| Street Address |
1203 S TYLER ST SUITE B |
| City | COVINGTON |
| State | LA |
| Zip Code | 70433-2329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225021207 | Wendy Anne Pratt | Nurse Practitioner | 1203 S Tyler St, Suite 200, Covington, LA 70433 | 2005-08-25 |
| 1629678214 | Ashley C Eusea | Dietitian, Registered | 1203 S Tyler St, Covington, LA 70433-2353 | 2020-11-01 |
| 1518453240 | Colleen Marie Hughes | Social Worker | 1203 S Tyler St, Covington, LA 70433-2353 | 2018-07-05 |
| 1275083529 | Ochsner Clinic LLC | General Practice | 1203 S Tyler St, Covington, LA 70433-2353 | 2016-10-11 |
| 1417389313 | Covington Cardiovascular Care At St. Tammany Parish Hospital | Nurse Practitioner | 1203 S Tyler St, Suite 210, Covington, LA 70433-2353 | 2013-08-01 |
| 1043518236 | Northshore Oncology Associates, LLC | Internal Medicine | 1203 S Tyler St, Ste 100, Covington, LA 70433-2353 | 2011-03-11 |
| 1811129000 | Richard Scott Bermudez | Radiology | 1203 S Tyler St, Ste 100, Covington, LA 70433-2353 | 2009-08-20 |
| 1518107275 | Jeffrey R Kitch | Nurse Practitioner | 1203 S Tyler St, Ste E, Covington, LA 70433-2353 | 2009-02-20 |
| 1265630826 | Chad Benjamin Vanasselberg | Internal Medicine | 1203 S Tyler St, Suite 200, Covington, LA 70433 | 2007-07-05 |
| 1154488997 | Allyson Marie Callahan | Nurse Practitioner | 1203 S Tyler St, Suite E, Covington, LA 70433-2353 | 2007-01-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790301018 | Caroline K. Wilson | Speech-Language Pathologist | 19105 Sandy Lane Suite A, Covington, LA 70433 | 2020-06-23 |
| 1568092013 | Tracy T Aljabi | Nurse Practitioner | 648 Crestwood Dr., Covington, LA 70433 | 2020-01-23 |
| 1093365462 | Maria Robert Hebrock | Marriage & Family Therapist | 71338 La-21, Suite 101, Covington, LA 70433 | 2019-09-17 |
| 1750930806 | Terry Fink Troxler | Speech-Language Pathologist | 521 Covington Point Dr, Covington, LA 70433 | 2019-09-10 |
| 1780231589 | Margaret Nordness Favre | Behavioral Analyst | 3999 Us-190, Covington, LA 70433 | 2019-08-26 |
| 1881241180 | Jennifer Ann Bacile | Counselor | 604 E 15th Street, Covington, LA 70433 | 2019-08-21 |
| 1356906689 | Moving and Caring Transportation LLC | Non-emergency Medical Transport (VAN) | 251 Vintage Drive, Covington, LA 70433 | 2019-05-02 |
| 1780153874 | Nga Endoscopy Center LLC | Clinic/Center | 7015 Hwy 190 E Service Road Suite 103, Covington, LA 70433 | 2018-11-19 |
| 1831667229 | Geauxprodme | Durable Medical Equipment & Medical Supplies | 1304 Champagne Street, Covington, LA 70433 | 2018-11-05 |
| 1376037994 | Pamela Ann Bernabo | Specialist/Technologist, Other | 80 Maison Drive, Covington, LA 70433 | 2018-06-18 |
| Find all providers in zip 70433 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588993679 | Vascular Access Center of North Shore Louisiana | Surgery | 915 South Harrison Street, Covington, LA 70433 | 2009-12-18 |
| 1033277991 | Venous & Arterial Surgery Clinic, LLC | Surgery | 180 Greenbriar Blvd, Covington, LA 70433-7233 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159790 | Cardiovascular Specialties of Louisiana LLC | Surgery | 3311 Prescott Rd Ste 312, Alexandria, LA 71301-3984 | 2020-06-20 |
| 1578942512 | Southern Vascular Associates LLC | Surgery | 127 Queensberry Dr, Lafayette, LA 70508-5421 | 2015-05-22 |
| 1821330093 | Laurel Hadley Hastings | Surgery | 7777 Hennessy Blvd Ste 1008, Baton Rouge, LA 70808 | 2013-03-26 |
| 1598001687 | Rodric Marsh Yeager | Surgery | 7717 Creswell Rd, 46, Shreveport, LA 71106-6000 | 2012-12-18 |
| 1730410408 | Vascular Specialty Center LLC | Surgery | 8888 Summa Ave Fl 3, Baton Rouge, LA 70809-3720 | 2010-01-20 |
| 1174624712 | Jon V. Schellack, M.d. (a Professional Medical Corporation) | Surgery | 5425 Brittany Dr # B, Baton Rouge, LA 70808-9144 | 2006-09-26 |
| 1003926981 | John Douglas Frusha | Surgery | 8595 Picandy Avenue, Suite 320, Baton Rouge, LA 70809-3675 | 2006-08-30 |
| 1164435475 | Stephen Collier White | Surgery | 1455 E Bert Kouns, Highland Clinic, Apmc, Shreveport, LA 71105 | 2006-08-15 |
| 1285645705 | Claudie Suzanne Mcarthur Sheahan Md | Surgery | 2820 Napoleon Ave Ste 700, New Orleans, LA 70115-8291 | 2006-08-10 |
| 1235152539 | Adam Christopher Hankins | Surgery | 2190 N. Causeway Blvd, Suite 150, Mandeville, LA 70471 | 2006-07-26 |
| Find all providers with the same taxonomy | ||||
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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.