Davey L Prout Jr. (NPI# 1780843607, PAC ID# 4587808266) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERVENTIONAL CARDIOLOGY.
| Nation Provider ID (NPI) | 1780843607 |
| PAC ID by PECOS | 4587808266 |
| Professional Enrollment ID | I20130919000218 |
| Full Name | Davey L Prout Jr. |
| Organization Legal Name | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Address |
214 Clinic Dr Donaldsonville LA 70346-4309 |
| Phone Number | 2257673900 |
| Gender | M |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduation Year | 2008 |
| Primary Specialty | INTERVENTIONAL CARDIOLOGY |
| Secondary Specialties | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Group Practice PAC ID | 4587849781 |
| Number of Group Practice Members | 474 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190064 | OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER |
| 190065 | BATON ROUGE GENERAL MEDICAL CENTER |
| 191308 | PREVOST MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 5000 Hennessy Blvd, Baton Rouge, LA 70808-4375 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC | |
| 5000 Hennessy Blvd, Suite 3, Baton Rouge, LA 70808-4375 | 2257658987 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| 7777 Hennessy Blvd, Baton Rouge, LA 70808-4363 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC | |
| 433 Plaza St, Bogalusa, LA 70427-3729 | 9857306706 | OUR LADY OF THE ANGELS HOSPITAL INC |
| 214 Clinic Dr, Donaldsonville, LA 70346-4309 | 2257673900 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5017 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC | |
| 17609 Old Jefferson Hwy, Prairieville, LA 70769-3980 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Organization Legal Name | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Physicians | 443 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Michael Robinson | Family Medicine | Our Lady of The Lake Physician Group LLC | 12525 Perkins Rd A, Baton Rouge, LA 70810-1907 |
| Kori Fogg Juban | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 34870 La Hwy 1019, Denham Springs, LA 70706-0659 |
| Michelle Duhe | Family Medicine | Our Lady of The Lake Physician Group LLC | 26739 La Hwy 1032, Denham Springs, LA 70726-4926 |
| Swapna G Kallu | Internal Medicine | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Montrell Martin-duhe | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 4463 La Hwy 1 S A, Port Allen, LA 70767-5990 |
| Joshua R Clark | Family Medicine | Our Lady of The Lake Physician Group LLC | 59315 River W Dr, Suite C, Plaquemine, LA 70764-6553 |
| Hollie B Ortis | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 13489 Hwy 431, Suite A, Saint Amant, LA 70774-3213 |
| Shantan Ravula | Family Medicine | Our Lady of The Lake Physician Group LLC | 14225 Hwy 73, Prairieville, LA 70769-3616 |
| Daniel Kevin Lavie | Hematology/oncology | Our Lady of The Lake Physician Group LLC | 4950 Essen Ln, Suite 400, Baton Rouge, LA 70809-3738 |
| Sheri A Ammons | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 5428 Odonovan Dr B, Baton Rouge, LA 70808-4374 |
| Street Address |
214 CLINIC DR |
| City | DONALDSONVILLE |
| State | LA |
| Zip | 70346-4309 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Swapna G Kallu | Internal Medicine | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Rachel Traigle Leonard | Physician Assistant | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Janet L Landry | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Marta H Robertson | Family Medicine | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Brooke B Borskey | Physician Assistant | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Lacy M Millet | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Michel I Hirsch | Family Medicine | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Glenn Schexnayder | Family Medicine | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Claire A Drummond | Physician Assistant | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Edward A Brauwn | Chiropractic | 7336 Hwy 1 S, Donaldsonville, LA 70346 | |
| Devjani Lahiri-munir | Optometry | Devjani Lahiri-munir, A Professional Corporation | 309 Iberville St, Donaldsonville, LA 70346-2421 |
| De'anna A Dark | Nurse Practitioner | Nagaratna Reddy M.d | 217 Railroad Ave, Donaldsonvlle, LA 70346-2527 |
| Wanda N Jefferson | Nurse Practitioner | Nagaratna Reddy M.d | 217 Railroad Ave, Donaldsonvlle, LA 70346-2527 |
| Nagaratna Reddy | Family Medicine | Nagaratna Reddy M.d | 217 Railroad Ave, Donaldsonvlle, LA 70346-2527 |
| Darrell Davis | Nurse Practitioner | Nagaratna Reddy M.d | 217 Railroad Ave, Donaldsonvlle, LA 70346-2527 |
| Megan Francesca Butler | Family Medicine | Capitol City Family Health Center, Incorporated | 904 Catalpa St, Donaldsonville, LA 70346-2946 |
| Michael E Hymbaugh | Internal Medicine | Capitol City Family Health Center, Incorporated | 904 Catalpa St, Donaldsonville, LA 70346-2946 |
| Gregory D Garner | Family Medicine | Capitol City Family Health Center, Incorporated | 904 Catalpa St, Donaldsonville, LA 70346-2946 |
| Jay Perniciaro | Chiropractic | 108 Memorial Dr, Donaldsonville, LA 70346-4337 | |
| Find all physicians in zip 70346 | |||
| City | DONALDSONVILLE |
| Zip Code | 70346 |
| Specialty | INTERVENTIONAL CARDIOLOGY |
| City + Specialty | DONALDSONVILLE + INTERVENTIONAL CARDIOLOGY |
Please comment or provide details below to improve the information on Davey L Prout Jr..
| 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.