Chakshu Gautam (NPI# 1952303240, PAC ID# 4082604582) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1952303240 |
| PAC ID by PECOS | 4082604582 |
| Professional Enrollment ID | I20040517000414 |
| Full Name | Chakshu Gautam |
| Organization Legal Name | JEFFERSON DAVIS EMERGENCY GROUP LLC |
| Address |
1634 Elton Rd Jennings LA 70546-3614 |
| Phone Number | 3376167160 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1992 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 2365496775 |
| Number of Group Practice Members | 17 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190053 | JENNINGS AMERICAN LEGION HOSPITAL |
| 191311 | BUNKIE GENERAL HOSPITAL |
| 190102 | OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC |
| Address | Phone | Organization |
|---|---|---|
| 427 Evergreen St, Bunkie, LA 71322-3901 | 3183466681 | EMERGENCY STAFFING SOLUTIONS INC |
| 1634 Elton Rd, Jennings, LA 70546-3614 | 3376167160 | JEFFERSON DAVIS EMERGENCY GROUP LLC |
| Organization Legal Name | JEFFERSON DAVIS EMERGENCY GROUP LLC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tiffany Le'shann Dugas | Emergency Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Harold W Bertrand | Nurse Practitioner | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Keith Davis Moffit | Emergency Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Melanie B White | Nurse Practitioner | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Jude Regis | Emergency Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Timothy S Magann | Emergency Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Chantel Burns | Family Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Syed Shah | Internal Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Susan A Wilhelm | Nurse Practitioner | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Street Address |
1634 ELTON RD |
| City | JENNINGS |
| State | LA |
| Zip | 70546-3614 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tiffany Le'shann Dugas | Emergency Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Harold W Bertrand | Nurse Practitioner | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| William K Caraway | Certified Registered Nurse Anesthetist (crna) | Jennings Anesthesia LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Brady R Drapekin | Family Medicine | Jefferson Davis Physician Services, LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Samer Bakhos | Family Medicine | Jefferson Davis Physician Services, LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Keith Davis Moffit | Emergency Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| William D Fontenot | Certified Registered Nurse Anesthetist (crna) | Jennings Anesthesia LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Melanie B White | Nurse Practitioner | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Jude Regis | Emergency Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Timothy S Magann | Emergency Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jerome F Gallien | Diagnostic Radiology | Aldes Rozas Md Inc | 1634 N Elton Rd, Jennings, LA 70546-3614 |
| Aldes J Rozas Iii | Diagnostic Radiology | Aldes Rozas Md Inc | 1634 N Elton Rd, Jennings, LA 70546-3614 |
| Chantel Burns | Family Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Syed Shah | Internal Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Michael D Marceaux | Certified Registered Nurse Anesthetist (crna) | Jennings Anesthesia LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Susan A Wilhelm | Nurse Practitioner | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Noorali W Jiwani | Family Practice | 1634 Elton Rd, Jennings, LA 70546-3614 | |
| Bonnie L Wirfs | Internal Medicine | Jefferson Davis Physician Services, LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Robert L Hanks | Chiropractic | 1607 Johnson St, Jennings, LA 70546-3621 | |
| Shane B Fontenot | Optometry | Advanced Family Eyecare, LLC | 1702 Johnson St, Jennings, LA 70546-3624 |
| Find all physicians in zip 70546 | |||
| City | JENNINGS |
| Zip Code | 70546 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | JENNINGS + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Chakshu Gautam.
| 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.