Jeremy W Henderson (NPI# 1336359652, PAC ID# 3971656695) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PATHOLOGY.
| Nation Provider ID (NPI) | 1336359652 |
| PAC ID by PECOS | 3971656695 |
| Professional Enrollment ID | I20100825000412 |
| Full Name | Jeremy W Henderson |
| Organization Legal Name | THE DELTA PATHOLOGY GROUP LLC |
| Address |
1202 S Tyler St Covington LA 70433-2330 |
| Phone Number | 9858984040 |
| Gender | M |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduation Year | 2004 |
| Primary Specialty | PATHOLOGY |
| Group Practice PAC ID | 4789639089 |
| Number of Group Practice Members | 51 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190045 | ST TAMMANY PARISH HOSPITAL |
| 190176 | TULANE MEDICAL CENTER |
| 190040 | SLIDELL MEMORIAL HOSPITAL |
| 190267 | FAIRWAY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 211 4th St, Alexandria, LA 71301-8421 | 3187693219 | THE DELTA PATHOLOGY GROUP LLC |
| 1202 S Tyler St, Covington, LA 70433-2330 | 9858984040 | THE DELTA PATHOLOGY GROUP LLC |
| 95 Judge Tanner Blvd, Covington, LA 70433-7500 | 9858674046 | THE DELTA PATHOLOGY GROUP LLC |
| 2915 Missouri Ave, Shreveport, LA 71109-4327 | 3186218820 | THE DELTA PATHOLOGY GROUP LLC |
| Organization Legal Name | THE DELTA PATHOLOGY GROUP LLC |
| Physicians | 53 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nancy V Smith | Pathology | The Delta Pathology Group LLC | 2915 Missouri Ave, Shreveport, LA 71109-4327 |
| Fleurette W Abreo | Pathology | The Delta Pathology Group LLC | 1101 Medical Ctr Blvd, Marrero, LA 70072-3147 |
| William P Long | Pathology | The Delta Pathology Group LLC | 1101 Medical Ctr Blvd, Marrero, LA 70072-3147 |
| Terence T Casey | Pathology | The Delta Pathology Group LLC | 1101 Medical Ctr Blvd, Marrero, LA 70072-3147 |
| Jill A Ferguson | Pathology | The Delta Pathology Group LLC | 2915 Missouri Ave, Shreveport, LA 71109-4327 |
| Jared D Barker | Pathology | The Delta Pathology Group LLC | 2915 Missouri Ave, Shreveport, LA 71109-4327 |
| Jonathan F Koehler | Pathology | The Delta Pathology Group LLC | 2915 Missouri Ave, Shreveport, LA 71109-4327 |
| Kirtesh H Patel | Pathology | The Delta Pathology Group LLC | 2915 Missouri Ave, Shreveport, LA 71109-4327 |
| William A Wesche | Pathology | The Delta Pathology Group LLC | 2915 Missouri Ave, Shreveport, LA 71109-4327 |
| Stephen P Blanchard | Pathology | The Delta Pathology Group LLC | 2915 Missouri Ave, Shreveport, LA 71109-4327 |
| Street Address |
1202 S TYLER ST |
| City | COVINGTON |
| State | LA |
| Zip | 70433-2330 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Justin M Owens | Diagnostic Radiology | Regional Radiology, LLC | 1202 S Tyler St, Covington, LA 70433-2330 |
| Jonah S Smith | Certified Registered Nurse Anesthetist (crna) | Total Anesthesia Care | 1202 S Tyler St, Covington, LA 70433-2330 |
| Geoffrey S Fendley | Certified Registered Nurse Anesthetist (crna) | Total Anesthesia Care | 1202 S Tyler St, Covington, LA 70433-2330 |
| Libeau J Berthelot | Family Medicine | St Tammany Parish Hospital Service District No 1 | 1202 S Tyler St, Covington, LA 70433-2330 |
| Christina M Pollet | Certified Registered Nurse Anesthetist (crna) | Total Anesthesia Care | 1202 S Tyler St, Covington, LA 70433-2330 |
| Katie B Taranto | Internal Medicine | St Tammany Parish Hospital Service District No 1 | 1202 S Tyler St, Covington, LA 70433-2330 |
| Haley R Davis | Emergency Medicine | St Tammany Emergency Physicians Group LLC | 1202 S Tyler St, Covington, LA 70433-2330 |
| Smita S Patel | Family Medicine | St Tammany Parish Hospital Service District No 1 | 1202 S Tyler St, Covington, LA 70433-2330 |
| John H Verhulst | General Surgery | St Tammany Parish Hospital Service District No 1 | 1202 S Tyler St, Covington, LA 70433-2330 |
| Heather L Haddad | Diagnostic Radiology | Regional Radiology, LLC | 1202 S Tyler St, Covington, LA 70433-2330 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cindy Pechon | Clinical Social Worker | 5001 U S Hwy 190 D4, Covington, LA 70433 | |
| Richard B Drude | Gastroenterology | Richard B. Drude, Jr., M.d., Apmc | 69150 Hwy 190, Covington, LA 70433 |
| Bruce S Samuels | Internal Medicine | 189 Greenbriar Blvd, Suite C, Covington, LA 70433 | |
| Nicholas J Viviano | Dermatology | 7031 Hwy 190, Covington, LA 70433 | |
| Thomas W Nielsen Jr. | Clinical Social Worker | 5001 Hwy 190, Suite B 1, Covington, LA 70433 | |
| Glenn D Hedgpeth | Gastroenterology | Dr. Bruce S. Samuels, LLC | 189 Greenbriar Blvd, Covington, LA 70433 |
| Brian C Cochran | Physical Therapy | Covington Physical Therapy Center | 129 Corporate Dr, Covington, LA 70433-1057 |
| Jonathan S Mitchell | Physical Therapy | Covington Physical Therapy Center | 129 Corporate Dr, Covington, LA 70433-1057 |
| Charles Balette | Family Medicine | 1119 S Tyler St, Covington, LA 70433-2327 | |
| Roy C Saguiguit | Internal Medicine | 1113 S Tyler St, Covington, LA 70433-2327 | |
| Find all physicians in zip 70433 | |||
| City | COVINGTON |
| Zip Code | 70433 |
| Specialty | PATHOLOGY |
| City + Specialty | COVINGTON + PATHOLOGY |
Please comment or provide details below to improve the information on Jeremy W Henderson.
| 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.