Provider Demographics
NPI:1477526275
Name:DEERE, PATRICK H (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:H
Last Name:DEERE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2539 VIKING DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2165
Mailing Address - Country:US
Mailing Address - Phone:318-747-8100
Mailing Address - Fax:318-747-8152
Practice Address - Street 1:2539 VIKING DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-1611
Practice Address - Country:US
Practice Address - Phone:318-747-8100
Practice Address - Fax:318-747-8152
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA27068207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1041009Medicaid
AR158170001Medicaid
31544OtherLA CDS
31544OtherLA CDS
31544OtherLA CDS
4J095Medicare PIN