Tyler Ladner (NPI# 1093100752, PAC ID# 5991024739) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1093100752 |
| PAC ID by PECOS | 5991024739 |
| Professional Enrollment ID | I20150429001926 |
| Full Name | Tyler Ladner |
| Organization Legal Name | MEA PRIMARY CARE PLUS, LLC |
| Address |
112 Southlake Cir Canton MS 39046-5368 |
| Phone Number | 6018598550 |
| Gender | M |
| Graduation Year | 2014 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0941583728 |
| Number of Group Practice Members | 48 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250048 | ST DOMINIC-JACKSON MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 112 Southlake Cir, Canton, MS 39046-5368 | 6018598550 | MEA PRIMARY CARE PLUS, LLC |
| 5606 Old Canton Rd, Jackson, MS 39211-4217 | 6019573333 | MEA PRIMARY CARE PLUS, LLC |
| 935 Hwy 51, Madison, MS 39110-8407 | 6018565986 | MEA PRIMARY CARE PLUS, LLC |
| 342 Gilchrist Dr, Pearl, MS 39208-6671 | 6019390700 | MEA PRIMARY CARE PLUS, LLC |
| Organization Legal Name | MEA PRIMARY CARE PLUS, LLC |
| Physicians | 50 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Moumita Do Biswas | Family Medicine | Mea Primary Care Plus, LLC | 106 Lake Vista Pl, Brandon, MS 39047-6384 |
| Heather Haynes Walker | Nurse Practitioner | Mea Primary Care Plus, LLC | 323 Hwy 51, Ridgeland, MS 39157-3428 |
| Brennan F Vaughn | Physician Assistant | Mea Primary Care Plus, LLC | 4204 Clay St, Vicksburg, MS 39183-3438 |
| Bethany Sumerford | Nurse Practitioner | Mea Primary Care Plus, LLC | 498 Hwy 80 E, Mea Primary Care Plu, Clinton, MS 39056-4720 |
| Michael L Brasel | Physician Assistant | Mea Primary Care Plus, LLC | 935 Hwy 51, Madison, MS 39110-8407 |
| Patrise Bennett | Family Medicine | Mea Primary Care Plus, LLC | 1777 Ellis Ave, Jackson, MS 39204-3616 |
| Diana Lynn Entrekin | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| John Brooks | Emergency Medicine | Mea Primary Care Plus, LLC | 342 Gilchrist Dr, Pearl, MS 39208-6671 |
| Robert L Russell | Family Medicine | Mea Primary Care Plus, LLC | 1515 Jefferson St, Laurel, MS 39440-4244 |
| Carole Lynne Singleton | Nurse Practitioner | Mea Primary Care Plus, LLC | 307 E Fifteenth St, Yazoo City, MS 39194-2631 |
| Street Address |
112 SOUTHLAKE CIR |
| City | CANTON |
| State | MS |
| Zip | 39046-5368 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan D. Lee | Family Medicine | Mea Primary Care Plus, LLC | 112 Southlake Cir, Canton, MS 39046-5368 |
| Gavin W Nowell | Physician Assistant | Mea Primary Care Plus, LLC | 112 Southlake Cir, Canton, MS 39046-5368 |
| Gabriel Martin Ibarra | Physician Assistant | Mea Primary Care Plus, LLC | 112 Southlake Cir, Canton, MS 39046-5368 |
| Jonathan G Flowers | Family Medicine | Mea Primary Care Plus, LLC | 112 Southlake Cir, Canton, MS 39046-5368 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rashad Smith | Physical Therapy | 3425 N Liberty St, Canton, MS 39046-3761 | |
| Marvin E Williams Ii | Occupational Therapy | Smart Therapy LLC | 3425 N Liberty St, Canton, MS 39046-3761 |
| James O Farrell Jr. | Physical Therapy | Visions Physical Therapy | 908 E Peace St, Canton, MS 39046-4024 |
| Marcus Harris | Physical Therapy | Visions Physical Therapy | 908 E Peace St, Canton, MS 39046-4024 |
| Mary A Johnson | Nurse Practitioner | 3276 S Liberty St, Canton, MS 39046-4516 | |
| Michael K Jones | Chiropractic | 134 E Peace St, Canton, MS 39046-4520 | |
| Reginald D Rigsby | Family Medicine | Psp Medical Clinic LLC | 1171 Hart St, Canton, MS 39046-4805 |
| Parvesh K Goel | Internal Medicine | Psp Medical Clinic LLC | 1171 Hart St, Canton, MS 39046-4805 |
| Phyllis Hammond | Clinical Social Worker | Psp Medical Clinic LLC | 1171 Hart St, Canton, MS 39046-4805 |
| David M Heumann | Physical Therapy | Peak Healthcare | 1421 E Peace St, Canton, MS 39046-4938 |
| Find all physicians in zip 39046 | |||
| City | CANTON |
| Zip Code | 39046 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | CANTON + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Tyler Ladner.
| 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.