Brian C Wilder (NPI# 1558455733, PAC ID# 6709782089) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1558455733 |
| PAC ID by PECOS | 6709782089 |
| Professional Enrollment ID | I20031209000070 |
| Full Name | Brian C Wilder |
| Organization Legal Name | IMPERIAL HEALTH LLP |
| Address |
1322 Elton Rd Suite H Jennings LA 70546-4100 |
| Phone Number | 3372467200 |
| Gender | M |
| Credential | MD |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT |
| Graduation Year | 1995 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 7719886779 |
| Number of Group Practice Members | 92 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190053 | JENNINGS AMERICAN LEGION HOSPITAL |
| 190064 | OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER |
| 190102 | OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC |
| 190044 | ACADIA GENERAL HOSPITAL |
| 190027 | CHRISTUS ST PATRICK HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1322 Elton Rd, Suite H, Jennings, LA 70546-4100 | 3372467200 | IMPERIAL HEALTH LLP |
| 4150 Nelson Rd, A3, Lake Charles, LA 70605-4169 | 3374747290 | IMPERIAL HEALTH LLP |
| 501 Doctor Michael Debakey Dr, Lake Charles, LA 70601-5724 | 3374338400 | IMPERIAL HEALTH LLP |
| Organization Legal Name | IMPERIAL HEALTH LLP |
| Physicians | 81 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Benjamin Scott Fontenot | Family Medicine | Imperial Health LLP | 277n Hwy 171, Suite 8, Lake Charles, LA 70611-5374 |
| Darci Landry Portie | Nurse Practitioner | Imperial Health LLP | 501 Doctor Michael Debakey Dr, Lake Charles, LA 70601-5724 |
| Brad W Lebert | Otolaryngology | Imperial Health LLP | 1920 W Sale Rd, Bldg F Suite 3 and 4, Lake Charles, LA 70605-2400 |
| Kara A Headington | Qualified Audiologist | Imperial Health LLP | 1615 Wolf Circle, Lake Charles, LA 70605-2348 |
| Benjamin Williams | Family Medicine | Imperial Health LLP | 771 Bayou Pines E Dr, Lake Charles, LA 70601-7183 |
| Rebecca Ellen Godare Stein | Nurse Practitioner | Imperial Health LLP | 600 Doctor Michael Debakey Dr, Lake Charles, LA 70601-5727 |
| Craig G Morton | Physical Medicine and Rehabilitation | Imperial Health LLP | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 |
| Brooke C Kennedy | Nurse Practitioner | Imperial Health LLP | 4201 Nelson Rd, Suite 100, Lake Charles, LA 70605-4117 |
| Samantha Ann Rider | Registered Dietitian Or Nutrition Professional | Imperial Health LLP | 4150 Nelson Rd, A3, Lake Charles, LA 70605-4169 |
| George J Trappey Iv | Orthopedic Surgery | Imperial Health LLP | 501 Doctor Michael Debakey Dr, Lake Charles, LA 70601-5724 |
| Street Address |
1322 ELTON RD SUITE H |
| City | JENNINGS |
| State | LA |
| Zip | 70546-4100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael J Benoit | Pediatric Medicine | Jeff Davis Family Medicine A Professional Medical Corporation | 1322 Elton Rd, Suite D, Jennings, LA 70546-4100 |
| Lam D Nguyen | Cardiovascular Disease (cardiology) | 1322 Elton Rd, Suite E, Jennings, LA 70546-3648 | |
| James E Mcnally | Family Medicine | Jeff Davis Family Medicine A Professional Medical Corporation | 1322 Elton Rd, Suite D, Jennings, LA 70546-4100 |
| Christopher J Achee | Family Medicine | Jeff Davis Family Medicine A Professional Medical Corporation | 1322 Elton Rd, Suite D, Jennings, LA 70546-4100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tiffany Le'shann Dugas | Emergency Medicine | Jefferson Davis Emergency Group LLC | 1634 Elton Rd, Jennings, LA 70546-3614 |
| Jerome F Gallien | Diagnostic Radiology | Aldes Rozas Md Inc | 1634 N 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 |
| Aldes J Rozas Iii | Diagnostic Radiology | Aldes Rozas Md Inc | 1634 N 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 |
| Find all physicians in zip 70546 | |||
| City | JENNINGS |
| Zip Code | 70546 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | JENNINGS + INTERNAL MEDICINE |
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| 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.