Joseph L Prud'homme (NPI# 1275571861, PAC ID# 3678616836) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1275571861 |
| PAC ID by PECOS | 3678616836 |
| Professional Enrollment ID | I20100210000323 |
| Full Name | Joseph L Prud'homme |
| Address |
1015 E Idel Tyler TX 75701-2025 |
| Phone Number | 9035928301 |
| Gender | M |
| Medical School | UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON |
| Graduation Year | 1962 |
| Primary Specialty | GENERAL SURGERY |
| Secondary Specialties | VASCULAR SURGERY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450083 | EAST TEXAS MEDICAL CENTER |
| 450102 | MOTHER FRANCES HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1015 E Idel, Tyler, TX 75701-2025 | 9035928301 |
| Street Address |
1015 E IDEL |
| City | TYLER |
| State | TX |
| Zip | 75701-2025 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jose L Enriquez | Diagnostic Radiology | Tyler Radiology Associates, Pa | 1100 S Beckham, Tyler, TX 75701 |
| Frank P Reuter Jr. | Internal Medicine | 712 S Bois D Arc Ave, Tyler, TX 75701-1503 | |
| Tammy L Michaelsen | Chiropractic | Michaelsen Chiropractic Center, P.C. | 645 S Broadway Ave, Suite 1, Tyler, TX 75701-1676 |
| Mark R Michaelsen | Chiropractic | Michaelsen Chiropractic Center, P.C. | 645 S Broadway Ave, Suite 1, Tyler, TX 75701-1676 |
| James Louis Wasson | Obstetrics/gynecology | 649 S Broadway Ave, Suite 2, Tyler, TX 75701-1677 | |
| Michael C Ford | Ophthalmology | 714 Turtle Creek Dr, Tyler, TX 75701-1833 | |
| Rosalyn L Gooch | Certified Registered Nurse Anesthetist (crna) | Novamed Surgery Center of Tyler, Lp | 802 Turtle Creek Dr, Tyler, TX 75701-1900 |
| Evans S Smith | Emergency Medicine | 833 S Beckham Ave, Tyler, TX 75701-1905 | |
| Li-yu H Mitchell | Family Medicine | 833 S Beckham Ave, Tyler, TX 75701-1905 | |
| Joseph Leonard Decarlo | Urology | Etmc Physician Group, Inc. | 911 S Beckham Ave, Tyler, TX 75701-1907 |
| Find all physicians in zip 75701 | |||
| City | TYLER |
| Zip Code | 75701 |
| Specialty | GENERAL SURGERY |
| City + Specialty | TYLER + GENERAL SURGERY |
Please comment or provide details below to improve the information on Joseph L Prud'homme.
| 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.