Amanda Lynn Callegan-poche'

MD | Pediatrics | Female

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Complete Profile:

Amanda Lynn Callegan-poche' basic information including her official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics
Provider Name :	Amanda Lynn Callegan-poche'
Other Name :	Amanda Lynn Callegan
Credential :	MD
Gender :	Female

Business Address:

Amanda Lynn Callegan-poche' address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	1023 Provenance Pl Ste 130 Shreveport, LA, 71106-7796 United States
Phone Number :	318-626-0000

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1265829394
NPI Entity Type :	Individual
First Enrolment Date :	15 Apr, 2015
Last Updated On :	04 Sep, 2019

Medicare Participation:

Amanda Lynn Callegan-poche' participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	1052614922
Medicare Enrollment ID :	I20190730000145
Primary Specialty :	Internal Medicine
Medical School :	Louisiana State University School Of Medicine In Shreveport
Graduation Year :	2015
Accepts Medicare?	Yes. Amanda Lynn Callegan-poche' accepts medicare insurance.

Group Practice Association:

Amanda Lynn Callegan-poche' is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Amanda Lynn Callegan-poche' is associated with along with the number of members in that group. She may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Lsu Health Sciences Center Shreveport Faculty Group Practice	4082902721	561	1606 Kings Hwy Shreveport, LA - 711034128 Ph: 3186756402	Yes
Lsu Health Sciences Center Shreveport Faculty Group Practice	4082902721	561	1541 Kings Hwy Shreveport, LA - 711034228 Ph: 3186755000	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Amanda Lynn Callegan-poche' are as mentioned. Primary taxonomy code for Amanda Lynn Callegan-poche', MD is 208000000X (Pediatrics).

Taxonomy Code	Speciality	Primary	License No.	State
208000000X	Pediatrics	Yes	312618	LA
207R00000X	Internal Medicine	No	312618	LA

Legacy Identifiers:

Other legacy medical identifiers of Amanda Lynn Callegan-poche' such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
2388312	MEDICAID	LA

Other Practice Locations:

Practice Address	City, State	Phone Number
1501 KINGS HWY, MED/PEDS SHREVEPORT, LA, 71103-4228 United States	SHREVEPORT, LA	318-813-2528

Endpoints:

Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	1501 Kings Hwy, Med/peds Shreveport, LA, 71103-4228 United States
Phone Number :	318-813-2528

Business Location:

Patients can refer following map for directions to Amanda Lynn Callegan-poche' practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.