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NPI Code Detail

MEDICARE: JERRY WAYNE SESSIONS M.D.

MEDICARE: JERRY WAYNE SESSIONS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician11639LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
211639OTHERLALSBME LICENSE
388006OTHERAR BLUE CROSS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
54982OTHERLA CDS

General Provider Information

NPI Number : 1174596910
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY WAYNE SESSIONS M.D.
Provider Business Mailing Address
First Line : 401 11TH ST NE
Second Line :
City : SPRINGHILL
State : LA
Zip : 71075-4503
Country : US
Telephone Number : 318-539-1700
Fax Number : 318-539-5688
Provider Business Practice Location Address
First Line : 401 11TH ST NE
Second Line :
City : SPRINGHILL
State : LA
Zip : 71075-4503
Country : US
Telephone Number : 318-539-1700
Fax Number : 318-539-5688
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 03/07/2023

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Directions to “ JERRY WAYNE SESSIONS M.D.” Practice Location

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