Larry C Daniels (NPI# 1700997160, PAC ID# 1052225422) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1700997160 |
PAC ID by PECOS | 1052225422 |
Professional Enrollment ID | I20031119000087 |
Full Name | Larry C Daniels |
Address |
350 Jordan St Shreveport LA 71101-4847 |
Gender | M |
Credential | MD |
Medical School | UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON |
Graduation Year | 1983 |
Primary Specialty | FAMILY MEDICINE |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
190111 | WILLIS KNIGHTON MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
350 Jordan St, Shreveport, LA 71101-4847 |
Street Address |
350 JORDAN ST |
City | SHREVEPORT |
State | LA |
Zip | 71101-4847 |
Name | Specialty | Organization | Address |
---|---|---|---|
Shawn E. Mcneil | Psychiatry | Wk Center for Psychiatric Support | 1111 Line Ave, Shreveport, LA 71101-3841 |
Jason M Broussard | Psychiatry | Wk Center for Psychiatric Support | 1111 Line Ave, Shreveport, LA 71101-3841 |
Kirsti N Peavy | Physician Assistant | Wk Center for Psychiatric Support | 1111 Line Ave, Shreveport, LA 71101-3841 |
Arien M Ward | Psychologist, Clinical | Wk Center for Psychiatric Support | 1111 Line Ave, Shreveport, LA 71101-3841 |
Devanshi Jani | Psychiatry | Wk Center for Psychiatric Support | 1111 Line Ave, Shreveport, LA 71101-3841 |
Albert M Aura | Internal Medicine | 1111 Line Ave, Shreveport, LA 71101-3841 | |
Jeffrey T Overdyke | Psychiatry | Wk Center for Psychiatric Support | 1111 Line Ave, Shreveport, LA 71101-3841 |
Caleb Blair Harkins | Nurse Practitioner | Wk North Pulmonary and Critical Care | 1202 Louisiana Ave, Shreveport, LA 71101-3910 |
Mark H Smith | General Surgery | Wk South Surgical Hospitalists | 1202 Louisiana Ave, Shreveport, LA 71101-3910 |
Matthew C Raley | Internal Medicine | Wk North Pulmonary and Critical Care | 1202 Louisiana Ave, Shreveport, LA 71101-3910 |
Find all physicians in zip 71101 |
City | SHREVEPORT |
Zip Code | 71101 |
Specialty | FAMILY MEDICINE |
City + Specialty | SHREVEPORT + FAMILY MEDICINE |
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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.