Dr TERRY B GARDNER MD is a male medical professional, specializing in Family Medicine. He graduated in 1992 from Louisiana State University School Of Medicine In Shreveport.
GREEN CLINIC LLC
1285 PINE ST
SUITE 104
ARCADIA
LA
710013120
Tel: 3182634420
| Npi | 1689644585 |
| Pac Id | 0547244691 |
| Professional Enrollment Id | I20040616000147 |
| Last Name | GARDNER |
| First Name | TERRY |
| Middle Name | B |
| Suffix | |
| Gender | M |
| Credential | MD |
| Medical School Name | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT |
| Graduation Year | 1992 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialty 1 | |
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| Organization Legal Name | GREEN CLINIC LLC |
| Group Practice Pac Id | 4789668831 |
| Number Of Group Practice Members | 72 |
| Line 1 Street Address | 1285 PINE ST |
| Line 2 Street Address | SUITE 104 |
| Marker Of Address Line 2 Suppression | |
| City | ARCADIA |
| State | LA |
| Zip Code | 710013120 |
| Phone Number | 3182634420 |
| Hospital Affiliation Ccn 1 | 191320 |
| Hospital Affiliation Lbn 1 | BIENVILLE MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | 190125 |
| Hospital Affiliation Lbn 2 | ST FRANCIS MEDICAL CENTER |
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| Professional Accepts Medicare Assignment | Y |
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