Provider Demographics
NPI:1780631168
Name:VENTERS, STEVEN W (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:W
Last Name:VENTERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:811 JAMES AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241-2237
Mailing Address - Country:US
Mailing Address - Phone:318-368-0190
Mailing Address - Fax:318-368-0405
Practice Address - Street 1:811 JAMES AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FARMERVILLE
Practice Address - State:LA
Practice Address - Zip Code:71241-2237
Practice Address - Country:US
Practice Address - Phone:318-368-0190
Practice Address - Fax:318-368-0405
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA12351R207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1699306Medicaid
LA721484656-712410000OtherCHAMPUS
LA721484656OtherOFFICE OF GROUP BENEFITS
LAG55011Medicare UPIN
LA5Y696Medicare ID - Type UnspecifiedMEDICARE PART B