Terry B Gardner (NPI# 1689644585, PAC ID# 0547244691) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1689644585 |
| PAC ID by PECOS | 0547244691 |
| Professional Enrollment ID | I20040616000147 |
| Full Name | Terry B Gardner |
| Organization Legal Name | GREEN CLINIC LLC |
| Address |
1285 Pine St Suite 104 Arcadia LA 71001-3120 |
| Phone Number | 3182634420 |
| Gender | M |
| Credential | MD |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT |
| Graduation Year | 1992 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 4789668831 |
| Number of Group Practice Members | 69 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190125 | ST FRANCIS MEDICAL CENTER |
| 191320 | BIENVILLE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1285 Pine St, Suite 104, Arcadia, LA 71001-3120 | 3182634420 | GREEN CLINIC LLC |
| 1200 S Farmerville St, Ruston, LA 71270-5941 | 3182516306 | GREEN CLINIC LLC |
| Organization Legal Name | GREEN CLINIC LLC |
| Physicians | 74 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wesley Lee Coleman | Physician Assistant | Green Clinic LLC | 1809 Northpointe Ln, 102 Green Clinic Quick Care of Ruston, Ruston, LA 71270-3852 |
| Ekara Wafer-mendenhall | Nurse Practitioner | Green Clinic LLC | 1402 Celebrity Dr, Ruston, LA 71270-3878 |
| Johnathan C Baines | Family Medicine | Green Clinic LLC | 3030 Hwy 80 W, Green Clinic Calhoun, Calhoun, LA 71225-7906 |
| Donna L Courson | Nurse Practitioner | Green Clinic LLC | 1200 S Farmerville St, Ruston, LA 71270-5941 |
| Gene Mariano | Physical Therapy | Green Clinic LLC | 4707 Quitman Hwy, Jonesboro, LA 71247-0001 |
| Jason Granger | Physical Therapy | Green Clinic LLC | 1200 S Farmerville, Ruston, LA 71270-5941 |
| Paul M Novakovich | Orthopedic Surgery | Green Clinic LLC | 1200 S Farmerville St, Ruston, LA 71270-5941 |
| Richard Ballard | Orthopedic Surgery | Green Clinic LLC | 1200 S Farmerville St, Ruston, LA 71270-5941 |
| Nancy Bourn Adkins | Nurse Practitioner | Green Clinic LLC | 1200 S Farmerville St, Ruston, LA 71270-5941 |
| William Sanders | Family Medicine | Green Clinic LLC | 1200 S Farmerville St, Ruston, LA 71270-5941 |
| Street Address |
1285 PINE ST SUITE 104 |
| City | ARCADIA |
| State | LA |
| Zip | 71001-3120 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Thomas | Nurse Practitioner | 2084 Myrtle St, Arcadia, LA 71001-3052 | |
| Susan L Wingo | Emergency Medicine | Sds Emergency Staffing LLC | 1175 Pine St, Arcadia, LA 71001-3121 |
| William K Johnson | Nurse Practitioner | Bienville Parish | 1175 Pine St, Suite 100, Arcadia, LA 71001-3122 |
| Angelia V Cooper | Nurse Practitioner | Bienville Parish | 1175 Pine St, Suite 100, Arcadia, LA 71001-3122 |
| City | ARCADIA |
| Zip Code | 71001 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | ARCADIA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Terry B Gardner.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.