Table of Contents. Affinity Health Network 1. NCQA PCMH Providers w/level 3 Recognition 11. Tier 1 Network: 16 Hospitals 17

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1 PARTICIPATING PROVIDER DIRECTORY Current as of - 04/01/2018 COMMERCIAL

2 Table of Contents Affinity Health Network 1 NCQA PCMH Providers w/level 3 Recognition 11 Tier 1 Network: 16 Hospitals 17 Region 1 19 (Caldwell, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Richland, Tensas, Union, West Carroll, Winn) Primary Care Physicians 19 Specialty Care Physicians 29 Ancillary Services 36 Region 2 49 (Bienville, Bossier, Caddo, Claiborne, DeSoto, Red River, Webster) Primary Care Physicians 49 Specialty Care Physicians 55 Ancillary Services 62 Region 3 71 (Avoyelles, Catahoula, Concordia, Grant, LaSalle, Natchitoches, Rapides, Sabine, Vernon) Primary Care Physicians 71 Specialty Care Physicians 77 Ancillary Services 82 Region 4 90 (Allen, Beauregard, Calcasieu, Cameron, Jefferson Davis) Primary Care Physicians 90 Specialty Care Physicians 92 Ancillary Services 96 Region (Acadia, Evangeline, Iberia, Lafayette, St. Landry, St. Martin, St. Mary, Terrebonne, Vermilion) Primary Care Physicians 102 Specialty Care Physicians 109 Ancillary Services 120 Region (Ascension, Assumption, East Baton Rouge, East Feliciana, Iberville, Livingston, Pointe Coupee, St. Helena, St. James, West Baton Rouge, West Feliciana) Primary Care Physicians 130 Specialty Care Physicians 143 Ancillary Services 160 Region (Jefferson, LaFourche, Orleans, Plaquemines, St. Bernard, St. Charles, St. John the Baptist, St. Tammany, Tangipahoa, Washington) Primary Care Physicians 174 Specialty Care Physicians 190 Ancillary Services 224

3 Affinity Health Network Affinity Health Network (AHN) is a preferred network of providers (physicians and facilities) who have partnered with Vantage Health Plan to offer Vantage members high quality medical services at lower copays. Page 1

4 HOSPITALS DESOTO REGIONAL HEALTH SYSTEM 207 JEFFERSON ST MANSFIELD, LA (318) FRANKLIN MEDICAL CENTER 2106 LOOP RD WINNSBORO, LA (318) MONROE SURGICAL HOSPITAL 2408 BROADMOOR BLVD (318) RICHLAND PARISH HOSPITAL 407 CINCINNATI ST DELHI, LA (318) RICHLAND PARISH HOSPITAL SERVICE DBA RICHARDSON MEDICAL CTR 256 HIGHWAY 3048 RAYVILLE, LA (318) WEST CARROLL HEALTH SYSTEMS 706 ROSS ST OAK GROVE, LA (318) REGION 1 Includes Ouachita, Lincoln, Morehouse, Union, Richland, East Carroll, West Carroll, Madison, Jackson, Caldwell, Franklin, Tensas and Winn Parishes. MEDICAL HOME - PCP's FAMILY PRACTICE ANDERS, KERRY L, 3400 MEDICAL PARK DR STE A MONROE, LA (318) ATKINS, LOGAN, 2104 C LOOP RD WINNSBORO, LA (318) HWY 17 WINNSBORO, LA (318) VERONA ST NEWELLTON, LA (318) NEWTON ST SAINT JOSEPH, LA (318) BANKS III, TOMMY G, 1900 NORTH 7TH ST (318) BARNES, DAVID L, 3400 MEDICAL PARK DR STE C MONROE, LA (318) CARLISLE, KEVIN M, 256 HWY 3048 RAYVILLE, LA (318) HWY 80 RAYVILLE, LA (318) COLEMAN, EDWARD O, DO 109 REGENCY PLACE (318) COLVIN, THOMAS L, 2106 LOOP RD STE A WINNSBORO, LA (318) COMBETTA, JEFFREY J, 2104 LOOP RD STE C WINNSBORO, LA (318) COTTER, MARK M, 2104C LOOP RD WINNSBORO, LA (318) COUGHRAN, JIMMY R, 1010 DAVIS LAKE RD COLUMBIA, LA (318) FAIR AVE WINNSBORO, LA (318) DOMINGUE, CHRISTOPHER M, 708 EAST MAIN ST OAK GROVE, LA (318) ELDRIDGE, JOEL G, DO 2104-C LOOD RD WINNSBORO, LA (318) LOOP RD WINNSBORO, LA (318) ENRIQUEZ, JOSE R, 508 BROADWAY ST DELHI, LA (318) GHANTA, SUMATHA, 920 OLIVER RD (318) GREEN, GREGORY R, 920 OLIVER RD WAITING AREA M (318) GUINIGUNDO, NOLI, 502 ROSS ST OAK GROVE, LA (318) GUJJULA, RAJESH, 920 OLIVER RD WAITING AREA J (318) HAYWARD SR, MICHAEL T, 3400 MEDICAL PARK STE B MONROE, LA (318) KERR, ALBERT G, 121 CHRISTIAN DR RAYVILLE, LA (318) LAPITE, OLADAPO, 306 STONE AVE (318) LE, DUNG N, 508 BROADWAY DELHI, LA (318) ELM ST DELHI, LA (318) MCDONALD III, KENNETH E, 508 BROADWAY ST DELHI, LA (318) MCMAHAN, STEVEN H, 1117 CHENIERE DREW RD (318) N 7TH ST (318) MELTON, STUART L, 920 OLIVER RD WAITING AREA J (318) MEYERS, OWEN M, 920 OLIVER RD WAITING AREA M (318) PATHAK, RISHI R, 706 ROSS STREET OAK GROVE, LA (318) PRINE, MATTHEW D, 256 HWY 3048 RAYVILLE, LA (318) HWY 80 RAYVILLE, LA (318) RAULERSON, ROBERT M, 112 SAINT JOHN ST (318) RICHARD, RINATA K, 2106 LOOP RD WINNSBORO, LA (318) (Hospitalist/Intensivist) ROSS, THERESA J, 112 SAINT JOHN ST (318) SANSON, MARSHALL V, 2309 ARKANSAS RD (318) STOCKSTILL, JAMES DEAN, 3510 MAGNOLIA AVE STE 190 MONROE, LA (318) THOMPSON, WILLIAM DAVID, 256 HWY 3048 RAYVILLE, LA (318) WILLIAMS SR, THOMAS ST CLAIR, 516 LINCOLN RD MONROE, LA (318) YARBROUGH, DAVID A, 3400 MEDICAL PARK DR STE B MONROE, LA (318) at any time. Please call (318) or go to to verify provider status. Page 2

5 INTERNAL MEDICINE ALBRITTON, COREY G, 508 BROADWAY ST DELHI, LA (318) ELM ST DELHI, LA (318) BRUYNINCKX, KYLE B, 261 HWY 132 MANGHAM, LA (318) FAKHRE, FAKHRE, 712 SETTOON ST OAK GROVE, LA (318) FAKHRE, GEORGE, 319 NORTH HOOD ST LAKE PROVIDENCE, LA (318) GRANDON, PAUL W, 508 BROADWAY ST DELHI, LA (318) HARTER, HERSCHEL R, 5975 FEDERAL HWY 80 RAYVILLE, LA (318) MASON, CHARLES WEBSTER, 920 OLIVER RD WAITING AREA L (318) MORGAN JR, CHARLES G, 920 OLIVER RD WAITING AREA L (318) RODGERS, JULIA S, 920 OLIVER RD WAITING AREA L (318) SAMPOGNARO, MICHAEL J, 1 BANCROFT CIR (318) SMITH JR, WILLIAM D, 2516 BROADMOOR BLVD (318) SMITH, ROGER A, 126 WATSON ST WISNER, LA (318) WAGNON, CYNTHIA S, 508 BROADWAY ST DELHI, LA (318) PEDIATRICS DYESS, BONITA H, 3401 MAGNOLIA CV MONROE, LA (318) EASON, MARGOT B, 920 OLIVER RD WAITING AREA K (318) FRANGIEH, AYFARAH M, 708 E MAIN ST OAK GROVE, LA (318) PALKAMSETTI, SIREESHA, 708 E MAIN ST OAK GROVE, LA (318) ZUKOWSKI, NANCY L, 3401 MAGNOLIA CV MONROE, LA (318) NON-PHYSICIAN PRACTITIONERS FAMILY PRACTICE BAILEY, JESSICA W, NP 2104 LOOP RD STE C WINNSBORO, LA (318) A LOOP RD WINNSBORO, LA (318) BENNETT, CRYSTAL, NP 256 HWY 3048 RAYVILLE, LA (318) HWY 80 RAYVILLE, LA (318) BENNETT, JENNIFER G, NP 5975 HWY 80 RAYVILLE, LA (318) CAMPER, YOLANDA S, NP 1140 UNIVERSITY AVE MONROE, LA (318) CASIDAY, JULIA M, NP 2104 LOOP RD STE C WINNSBORO, LA (318) CHAUVIN, JANNA C, NP 2104 LOOP RD STE C WINNSBORO, LA (318) LOOP RD WINNSBORO, LA (318) HWY 17 WINNSBORO, LA (318) VERONA ST NEWELLTON, LA (318) NEWTON ST SAINT JOSEPH, LA (318) COLEMAN, EULA F, NP 2104 LOOP RD STE C WINNSBORO, LA (318) LOOP RD WINNSBORO, LA (318) HWY 17 WINNSBORO, LA (318) VERONA ST NEWELLTON, LA (318) NEWTON ST SAINT JOSEPH, LA (318) COPELAND, ELIZABETH H, NP 112 SAINT JOHN ST (318) OLIVER ROAD (318) DEAR, SHARON T, NP 2309 ARKANSAS RD (318) ERWIN, LAUREN S, NP 920 OLIVER RD WAITING AREA L (318) FLEMISTER, MELISSA K, NP 920 OLIVER RD WAITING AREA M (318) FLORICE, JOE C, NP 2104 LOOP RD STE C WINNSBORO, LA (318) LOOP RD WINNSBORO, LA (318) HWY 17 WINNSBORO, LA (318) VERONA ST NEWELLTON, LA (318) NEWTON ST SAINT JOSEPH, LA (318) GRIMMETT, RYAN P, NP 112 SAINT JOHN ST (318) HALE, ASHLEY N, NP 261 HWY 132 MANGHAM, LA (318) HARRIS, RECEL, NP 508 BROADWAY ST DELHI, LA (318) HAUGHT, HALEY A, NP 109 ELM ST DELHI, LA (318) HAYDEN, BENJAMIN W, NP 518 DURHAM ST BASTROP, LA (318) N 16TH ST MER ROUGE, LA (318) BROADWAY ST DELHI, LA (318) HIGHWAY 132 MANGHAM, LA (318) TAYLOR ST MARION, LA (318) at any time. Please call (318) or go to to verify provider status. Page 3

6 HAYDEN, ERIN E, NP 112 SAINT JOHN ST (318) OLIVER RD (318) HEUDUCK, JULIE, NP 2104 LOOP RD STE C WINNSBORO, LA (318) HWY 17 WINNSBORO, LA (318) VERONA ST NEWELLTON, LA (318) NEWTON ST SAINT JOSEPH, LA (318) HOWARD, SUSAN A, NP 126 WATSON ST WISNER, LA (318) HUGGINS, JOY R, NP 2516 BROADMOOR BLVD STE 2A (318) LOCKARD, JOYCE P, NP 2106 LOOP RD WINNSBORO, LA (318) A LOOP RD WINNSBORO, LA (318) HWY 17 WINNSBORO, LA (318) VERONA ST NEWELLTON, LA (318) NEWTON ST SAINT JOSEPH, LA (318) LONSBERRY, KATHRYN A, PA 2106 A LOOP RD WINNSBORO, LA (318) LOWDER, RAYNE W, NP 109 REGENCY PLACE (318) MCCRORY, JULIE, NP 2309 ARKANSAS RD (318) MCVAY, ALISHA N, NP 106 TOOMB ST DELHI, LA (318) BROADWAY ST DELHI, LA (318) MAIN ST DELHI, LA (318) ELM ST DELHI, LA (318) HWY 17 DELHI, LA (318) MILLER, BRENDA R, NP 2104 LOOP RD STE C WINNSBORO, LA (318) LOOP RD WINNSBORO, LA (318) HWY 17 WINNSBORO, LA (318) VERONA ST NEWELLTON, LA (318) NEWTON ST SAINT JOSEPH, LA (318) OLDHAM, AIMEE D, NP 3400 MEDICAL PARK DR STE B MONROE, LA (318) PARKER, KAREN B, NP 920 OLIVER RD WAITING AREA L (318) PEARSON, NATHAN E, NP 2309 ARKANSAS RD (318) PRUDEN, AMY L, NP 920 OLIVER RD WAITING AREA J (318) ROSS, CHRISTINA D, NP 920 OLIVER RD WAITING AREA M (318) SCHOOLEY, JARROD L, PA 2309 ARKANSAS RD (318) SPENCER, ERIKA, NP 109 REGENCY PLACE (318) STEPHENS, MATILDA E, NP 3400 MEDICAL PARK DR STE B MONROE, LA (318) SULLIVAN, SHARLENE C, NP 2408 BROADMOOR BLVD STE B (318) OLIVER RD WAITING AREA A (318) THOMASON, DEANNA W, NP 106 TOOMB ST DELHI, LA (318) MAIN ST DELHI, LA (318) ELM ST DELHI, LA (318) BROADWAY ST DELHI, LA (318) HWY 17 DELHI, LA (318) WEGNER, MATTHEW, NP 706 ROSS ST OAK GROVE, LA (318) WILLSHER, LAURA B, NP 112 ST JOHN ST (318) YELVERTON, EMILIANA M, NP 2408 BROADMOOR BLVD STE B (318) INTERNAL MEDICINE CAIN, PENNY P, NP 112 SAINT JOHN ST (318) OLIVER RD WAITING AREA L (318) PEDIATRICS BAILEY, PAMELA J, NP 2106A LOOP RD WINNSBORO, LA (318) HWY 17 WINNSBORO, LA (318) VERONA ST NEWELLTON, LA (318) NEWTON ST SAINT JOSEPH, LA (318) CARR, VIVIAN S, NP 3401 MAGNOLIA CV MONROE, LA (318) DAVIS, MARYANNE S, NP 920 OLIVER RD WAITING AREA K MONROE, LA (318) DUCKWORTH-HOWARD, APRIL, NP 920 OLIVER RD WAITING AREA K (318) GRIFFING, PAULA, NP 2104 C LOOP RD WINNSBORO, LA (318) WEBB, STACY D, NP 3401 MAGNOLIA COVE MONROE, LA (318) MEDICAL PARK DR MONROE, LA (318) at any time. Please call (318) or go to to verify provider status. Page 4

7 SPECIALISTS CARDIOVASCULAR DISEASE BARROW, EMILE A, 1100 NORTH 18TH ST (318) FULLER, NICOLE L, NP 2516 BROADMOOR BLVD STE 2C (318) HILBUN, JEFFREY M, 2516 BROADMOOR BLVD STE 2C (318) KOEPKE, RONALD P, 2516 BROADMOOR BLVD STE 2C (318) MANRIQUE GARCIA, ALVARO F, 2516 BROADMOOR BLVD STE 2A (318) NAPOLI, MARK C, 1100 N 18TH ST (318) RITTELMEYER, JAMES T, 1100 N 18TH ST (318) SAMPOGNARO, GREGORY C, 2516 BROADMOOR AVE STE 2B (318) EAR, NOSE & THROAT/OTOLARYNGOL OGY BARHAM, WILSON T, 2802 KILPATRICK BLVD (318) MICKEY, LAUREN J, 102 THOMAS RD STE 117 (318) MILLER, LEE A, 2802 KILPATRICK BLVD (318) NORRIS, JOEL W, 2516 BROADMOOR BLVD STE 1B (318) TALIAFERRO JR, HENRY G, 2516 BROADMOOR BLVD STE 1B (318) WALTON, AUDREY A, NP 102 THOMAS RD STE 117 (318) OBSTETRICIAN AND GYNECOLOGIST ARMSTRONG, RAFAEL B, 3408 MEDICAL PARK DR MONROE, LA (318) BRYAN, DAVID G, 931 NORTH TRENTON ST (318) ST JOHN ST STE 2 (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) MCMILLAN RD (318) CLARK, DELLIE H, 931 NORTH TRENTON ST (318) ST JOHN ST STE 2 (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) (GYN Only) 417 MCMILLAN RD (318) HALL, PEYTON R, 931 NORTH TRENTON ST (318) ST JOHN ST STE 2 (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) (GYN Only) 417 MCMILLAN RD (318) JACKSON, PHYLLIS G, 931 NORTH TRENTON ST (318) ST JOHN ST STE 2 (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) MCMILLAN RD (318) KLUG, SARA J, DO 312 GRAMMONT ST STE 300 (318) LEBLEU VASZILY, LAURIE R, 931 NORTH TRENTON ST (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) ST JOHN ST STE 2 (318) MCMILLAN RD (318) LEE, WON S, 931 NORTH TRENTON ST (318) ST JOHN ST STE 2 (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) MCMILLAN RD (318) PENNEBAKER, DAWN W, 931 NORTH TRENTON ST (318) ST JOHN ST STE 2 (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) MCMILLAN RD (318) PETTY, LAURA R, 931 NORTH TRENTON ST (318) ST JOHN ST STE 2 (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) MCMILLAN RD (318) SHEMWELL, AMBER L, 931 NORTH TRENTON ST (318) at any time. Please call (318) or go to to verify provider status. Page 5

8 711 ST JOHN ST STE 2 (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) MCMILLAN RD (318) TUGWELL, TERRY, 931 NORTH TRENTON ST (318) ST JOHN ST STE 2 (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) MCMILLAN RD (318) WILLIAMS, ADRIENNE M, 312 GRAMMONT ST STE 300 (318) ST JOHN ST STE 2 (318) MEDICAL PARK DR STE 1 MONROE, LA (318) MCMILLAN RD (318) WILSON, JASON B, 931 NORTH TRENTON ST (318) ST JOHN ST STE 2 (318) TOWER DR STE 406 (318) GRAMMONT ST STE 300 (318) MCMILLAN RD (318) OPHTHALMOLOGY APT, RICHARD K, 1310 N 19TH ST (318) BARRON, JOSEPH B, 3101 MERCEDES DR (318) COOKSEY, JOHN C, 1310 N 19TH ST (318) FERNANDES, JOSHUA K, 3101 MERCEDES DR (318) READ, WILLIAM JASON, 2600 TOWER DR STE 111 (318) ORTHOPEDIC SURGERY BROWN, DOUGLAS C, 312 GRAMMONT ST STE 302 (318) PROFESSIONAL DR (318) CHRISTIAN DR RAYVILLE, LA (318) HOUSEWORTH, STEPHEN W, 2516 BROADMOOR BLVD STE 1D (318) SOELLER SR, CLEMENS E, 2516 BROADMOOR BLVD STE 1A (318) PSYCHIATRY RAGSDILL, ROY R, 920 OLIVER RD WAITING AREA H (318) SURGERY-GENERAL GUTIERREZ, DAVID, 2106 LOOP RD WINNSBORO, LA (318) LOOP RD STE E WINNSBORO, LA (318) LILES, WILLIAM BART, 2516 BROADMOOR BLVD STE 3C (318) MARX, DARYL S, 2301 JUSTICE ST (318) SARTOR, WALTER M, 2516 BROADMOOR BLVD STE 3C (318) SMITH JR, JAMES P, 2516 BROADMOOR BLVD STE 3C (318) SURGERY-NEUROLOGY CAIN, MARSHALL A, 2485 TOWER DR STE 9 MONROE, LA (318) SURGERY-PLASTIC MICKEL, TIMOTHY J, 903 NORTH 2ND ST (318) UROLOGY DEAN JR, ODELL J, 2516 BROADMOOR BLVD STE 3B (318) HUMBLE, ROBERT LEE, 2516 BROADMOOR BLVD STE 3B (318) JOHNSON, J BRADLEY, 2516 BROADMOOR BLVD (318) MARX, ROBERT D, 102 THOMAS RD STE 108 (318) MURPHY, PAUL G, 2516 BROADMOOR BLVD (318) ROBINSON, JED C, DO 2106 LOOP RD WINNSBORO, LA (318) Ancillary Services AFTER HOURS CLINIC AFFINITY CHILDREN & FAMILY WALK IN CLINIC 920 OLIVER RD WAITING AREA A (318) COMMUNITY/RURAL HEALTH CENTER FRANKLIN MEDICAL CENTER RHC NEWELLTON 104 VERONA ST NEWELLTON, LA (318) FRANKLIN MEDICAL CENTER RHC ST JOSEPH 448 NEWTON ST SAINT JOSEPH, LA (318) DENTIST CRUSE STRONG, MARIANNE, DDS 502 ROSS ST OAK GROVE, LA (318) DIAGNOSTIC TESTING FACILITY DELTA DIAGNOSTICS 2408 BROADMOOR BLVD (318) HEARING CENTER/AUDIOLOGIST PETTIT, LORRA M, AUD 2516 BROADMOOR BLVD (318) at any time. Please call (318) or go to to verify provider status. Page 6

9 2802 KILPATRICK BLVD (318) NUTRITIONAL COUNSELING BRANTLY, CYNTHIA A, RD 1325 LOUISVILLE AVE (318) DEAN, SARA (KATIE) W, RD 1325 LOUISVILLE AVE (318) WEST, CYNTHIA FISHER, RD 1325 LOUISVILLE AVE (318) WOOD, AMANDA L, RD 1325 LOUISVILLE AVE (318) SUBSTANCE ABUSE/PSYCH CRAYTON, SUZETTE M, LCSW 920 OLIVER RD (318) WILSON, KATHERINE M, LMFT 2600 TOWER DR STE 406 (318) THERAPY CENTER BORDELON, TAMARA L, PT 1325 LOUISVILLE AVE (318) BROWN, APRIL J, PT 1325 LOUISVILLE AVE (318) CAMPBELL, CHRISTOPHER RYAN, PT 1325 LOUISVILLE AVE (318) LEGGITT, SARA K, SLP 1325 LOUISVILLE AVE (318) STUBBS AVE (318) MAJURE, STACEY G, PT 1325 LOUISVILLE AVE (318) MEDICAL PARK DR MONROE, LA (318) MARTIN, EMILY A, SLP 1325 LOUISVILLE AVE (318) MCDONALD, LAURA L, OT 1325 LOUISVILLE AVE (318) SANFORD, ALISON L, PT 1325 LOUISVILLE AVE (318) REGION 2 Includes Caddo, Bossier, Red River, Bienville, Claiborne, Webster, and DeSoto Parishes. MEDICAL HOME - PCP's FAMILY PRACTICE EVANS, JEFFREY L, 130 JEFFERSON ST MANSFIELD, LA (318) SAWYER, DOUGLAS C, 130 JEFFERSON ST MANSFIELD, LA (318) (Hospitalist/Intensivist) INTERNAL MEDICINE NON-PHYSICIAN PRACTITIONERS FAMILY PRACTICE EUBANKS, LORI A, NP 130 JEFFERSON ST MANSFIELD, LA (318) RICHARDSON, MELISSA L, NP 808 MAIN ST LOGANSPORT, LA (318) TAYLOR, ANGELA OWENS, NP 130 JEFFERSON ST MANSFIELD, LA (318) Ancillary Services COMMUNITY/RURAL HEALTH CENTER DESOTO REGIONAL FAMILY MEDICINE - LOGANSPORT 808 MAIN ST LOGANSPORT, LA (318) DESOTO REGIONAL FAMILY MEDICINE - MANSFIELD 130 JEFFERSON ST MANSFIELD, LA (318) REGION 3 Includes Sabine, Natchitoches, Vernon, Rapides, Concordia, Avoyelles, Catahoula, LaSalle, and Grant Parishes. MEDICAL HOME - PCP's FAMILY PRACTICE SAWYER, DOUGLAS C, 2026 OBRIE ST ZWOLLE, LA (318) NON-PHYSICIAN PRACTITIONERS FAMILY PRACTICE FRYAR KELONE, SUSAN T, NP 302A BUSHLEY STREET HARRISONBURG, LA (318) CHISUM ST SICILY ISLAND, LA (318) GRAY, CYNTHIA M, NP 307 CHISUM ST SICILY ISLAND, LA (318) HOWARD, SUSAN A, NP 302A BUSHLEY ST HARRISONBURG, LA (318) OLIVIER, ASHLEY B, NP 307 CHISUM ST SICILY ISLAND, LA (318) PORTER, MARY E, NP 307 CHISUM ST SICILY ISLAND, LA (318) WEBBER JR, JOSEPH K, NP 307 CHISUM ST SICILY ISLAND, LA (318) SERIO BLVD FERRIDAY, LA (318) Ancillary Services DENTIST POWERS, TNONEALYER G, D 710 CHISUM ST SICILY ISLAND, LA (318) CASTEEL, EMILY E, SLP 1325 LOUISVILLE AVE (318) LAMB, BRIAN K, OT 1325 LOUISVILLE AVE (318) KAMBEROV, DENIS F, 808 MAIN ST LOGANSPORT, LA (318) JEFFERSON ST MANSFIELD, LA (318) INTERNAL MEDICINE SMITH, ROGER A, 302A BUSHLEY ST HARRISONBURG, LA (318) at any time. Please call (318) or go to to verify provider status. Page 7

10 REGION 6 Includes Livingston, Assumption, West Feliciana, East Feliciana, Iberville, St. Helena, St. James, East Baton Rouge, West Baton Rouge, Pointe Coupee and Ascension Parishes. MEDICAL HOME - PCP's FAMILY PRACTICE VARNADO, JIMMIE W, 6214 HWY 10 GREENSBURG, LA (225) INTERNAL MEDICINE ALBERGAMO, IGNAZIO JOSEPH, ALVAREZ, FRANK J, AUSTIN, CHRISTINA URIEGAS, BABIN, KEVIN J, BALART, JAMES C, BARBIN, ALLISON B, BORDELON, ASHLEY D, 230 ROBERTS DR STE I NEW ROADS, LA (225) BRANDT, HAROLD D, BRUCE, ZACKARY, (225) CARLISLE, CASEY B, COOLEY, RICHARD TODD, CROCKETT, JEWEL W, DOUCET, DONALD W, 230 ROBERTS DR STE 1 NEW ROADS, LA (225) FALCON, LARA M, FONTENOT, CODEY L, FONTENOT, DAVID W, GRAVES, KURT W, GREESON, JENNIFER C, GRUNER, RACHEL M, HINES, WILLIAM H, JONES, MAUREEN E, KADAIR, ROY G, KAHN, JEFFREY M, LANDRY, ADRIAN P, LARRIVIERE, JOSEPH A, LIEUX, THEODORE RICHARD, PENN, WESLEY J, ROLFSEN, MICHAEL L, SAY, GEORGE D, TALBOT, KRISTEN D, TREUIL, REBECCA S, TUMMINELLO JR, VINCENT V, VINCI, EDMUND B, WAGUESPACK, ERIC M, WEST, J DAVID, (225) WHARTON, J SCOTT, (225) WINBURN, RICKY C, PEDIATRICS BANKSTON, SUSAN M, BOMBET, RONALD L, BOUDREAUX, LAURA M, INDUSTRIPLEX BLVD (225) BRUMUND, TRACI T, CALANDRO, MINDY L, DRUMM, ROBERT, FRANZ, SANDRA A, GUIDROZ, JENNIFER T, HOLMES, CHRISTINA H, KATZENMEYER, CATHERINE C, MARTIN, SHELLEY, MASON, LYNN S, at any time. Please call (318) or go to to verify provider status. Page 8

11 MELTON, JAMAR A, RAMEY, STEWART, SEITER, ELIZABETH D, TRIBOU, ARTHUR G, WAGGENSPACK, MARK J, WHATLEY, PATRICIA D, WOOD, DANNY S, (225) NON-PHYSICIAN PRACTITIONERS FAMILY PRACTICE BOWDEN, BETHANY B, NP BROUSSARD, KRISTEN F, NP SPECIALISTS ALLERGY & IMMUNOLOGY REDHEAD JR, JOSEPH N, 7373 PERKINS ROAD DERMATOLOGY EARHART, ROBERT N, 3401 NORTH BLVD STE 200 (225) FREDERIC, JEFFREY E, FREDERIC, STEPHANIE R, JACKSON, SCOTT M, 1401 N FOSTER DR (225) MURPHY, COURTNEY M, WAMPOLD, JAN B, 5000 HENNESSY BLVD (225) EAR, NOSE & THROAT/OTOLARYNGOL OGY BRINGAZE, VIRGINIA A, CLEMENTS, KELLY S, HARDY, ELLIOT T, KATZENMEYER, WILLIAM K, KRUPALA, JAMES L, PETIT, BRIAN J, ENDOCRINOLOGY FIELD, GARY H, HINKLE, JEANNEMARIE D, MILLER, GENA T, (225) MORAN, TIMOTHY P, SILVERBERG, JOEL D, WELDEN, JONATHAN G, (225) GASTROENTEROLOGY ARBOUR JR, GERALD T, CAUBLE, STEPHANIE M, GUIDROZ, ANDREW D, (225) HIRSCH, GARY S, NEUROLOGIST - PEDIATRIC SCHEXNAYDER, LALANIA K, 8415 GOODWOOD BLVD STE 202 (225) NEUROLOGY DYNES, GERARD J, GLADNEY JR, WILLIAM W, LEBOURGEOIS, LINDA, MURPHY, BRIAN P, OLIVEIRA, PEDRO S, PULMONARY DISEASES HINKLE, ROBERT C, HODGES, MARK K, MCCARTHY, MICHAEL P, RHEUMATOLOGY BOURG, ANGELE D, 5131 O DONOVAN DR STE 400 (225) CERUTI, RONALD P, (225) ODONOVAN DR STE 500 BATON ROUGE, LA (225) at any time. Please call (318) or go to to verify provider status. Page 9

12 CUCURULL, ELENA C, 5131 ODONOVAN DR STE 400 (225) MARSHALL, JOHN E, MENA, HECTOR R, POLLET, STEPHEN M, 5131 ODONOVAN STE 400 BATON ROUGE, LA (225) SURGERY-GENERAL FROELICH, JAMES A, TAYLOR, JONATHAN P, SURGERY-VASCULAR SCHWARTZBERG, GLEN J, UROLOGY INGERMAN, ALEXANDER, PORTA, WESLEY R, SCHMEECKLE, AYME V, Ancillary Services OPTOMETRIST MARTIN, ADAM C, OD REGION 7 Includes Tangipahoa, LaFourche, St. Charles, St. John the Baptist, St. Tammany, Plaquemines, Jefferson, Orleans, Washington and St. Bernard Parishes. MEDICAL HOME - PCP's FAMILY PRACTICE ALLEN, GREGORY J, 105 EAST OAK ST PONCHATOULA, LA (985) GAUDIN, STEVE L, 105 EAST OAK ST PONCHATOULA, LA (985) GILBREATH JR, CLAUDE W, DOCTORS BLVD PONCHATOULA, LA (985) KOZEL, MICHAEL J, 165 W OAK ST PONCHATOULA, LA (985) SMITH, SMITTY, DOCTORS BLVD (985) TREANOR, LEONARD C, PELICAN PROFESSIONAL PARK (985) WALKER JR, JOHN A, DOCTORS BLVD (985) INTERNAL MEDICINE CAULFIELD, KYLE L, PELICAN PROFESSIONAL PK (985) DRUMMOND, DARREN M, PELICAN PROFESSIONAL PARK (985) PICOU, SCOTT B, PELICAN PROFESSIONAL PARK (985) ROBLEDO, RAPHAEL O, MEDICAL ARTS PLAZA (985) STEVENS, NICHOLAS, PELICAN PROFESSIONAL PARK (985) WINKLER, MARGARET L, MEDICAL ARTS PLZ (985) SPECIALISTS OPHTHALMOLOGY APT, RICHARD K, 1101 AUDUBON AVE STE N5 THIBODAUX, LA (985) at any time. Please call (318) or go to to verify provider status. Page 10

13 NCQA PCMH Providers w/ Level 3 Recognition The National Committee for Quality Assurance ( NCQA ) is a private, nonprofit organization that accredits and certifies a wide range of health care organizations and physicians. The physicians listed below are recognized by the NCQA for their efforts in the advancement of health care quality. The Patient-Centered Medical Home (PCMH) program emphasizes the use of systematic, patient-centered, coordinated care that supports access, communication and patient involvement. Page 11

14 REGION 1 Includes Ouachita, Lincoln, Morehouse, Union, Richland, East Carroll, West Carroll, Madison, Jackson, Caldwell, Franklin, Tensas and Winn Parishes. MEDICAL HOME - PCP's FAMILY PRACTICE GHANTA, SUMATHA, 920 OLIVER RD (318) GREEN, GREGORY R, 920 OLIVER RD WAITING AREA M (318) GUJJULA, RAJESH, 920 OLIVER RD WAITING AREA J (318) HAYWARD SR, MICHAEL T, 3400 MEDICAL PARK STE B MONROE, LA (318) MELTON, STUART L, 920 OLIVER RD WAITING AREA J (318) MEYERS, OWEN M, 920 OLIVER RD WAITING AREA M (318) RAULERSON, ROBERT M, 112 SAINT JOHN ST (318) YARBROUGH, DAVID A, 3400 MEDICAL PARK DR STE B MONROE, LA (318) INTERNAL MEDICINE ALBRITTON, COREY G, 508 BROADWAY ST DELHI, LA (318) ELM ST DELHI, LA (318) BRUYNINCKX, KYLE B, 261 HWY 132 MANGHAM, LA (318) MORGAN JR, CHARLES G, 920 OLIVER RD WAITING AREA L (318) SAMPOGNARO, MICHAEL J, 1 BANCROFT CIR (318) SMITH JR, RICHARD D, 3510 MAGNOLIA CV STE 120 MONROE, LA (318) PEDIATRICS CHISLEY, TYWANNA L, 2913 DESIARD ST (318) BETIN AVE (318) S 2ND ST MONROE, LA (318) DYESS, BONITA H, 3401 MAGNOLIA CV MONROE, LA (318) ZUKOWSKI, NANCY L, 3401 MAGNOLIA CV MONROE, LA (318) NON-PHYSICIAN PRACTITIONERS FAMILY PRACTICE BROWN, AMANDA K, NP 309 JACKSON ST (318) FLEMISTER, MELISSA K, NP 920 OLIVER RD WAITING AREA M (318) GRIMMETT, RYAN P, NP 112 SAINT JOHN ST (318) HAUGHT, HALEY A, NP 109 ELM ST DELHI, LA (318) HAYDEN, BENJAMIN W, NP 518 DURHAM ST BASTROP, LA (318) N 16TH ST MER ROUGE, LA (318) BROADWAY ST DELHI, LA (318) HIGHWAY 132 MANGHAM, LA (318) TAYLOR ST MARION, LA (318) LOWDER, RAYNE W, NP 109 REGENCY PLACE (318) POPE, SHEILA Y, NP 2913 DESIARD ST (318) BETIN AVE (318) S 2ND ST MONROE, LA (318) PRUDEN, AMY L, NP 920 OLIVER RD WAITING AREA J (318) ROSS, CHRISTINA D, NP 920 OLIVER RD WAITING AREA M (318) STEPHENS, MATILDA E, NP 3400 MEDICAL PARK DR STE B MONROE, LA (318) WILLSHER, LAURA B, NP 112 ST JOHN ST (318) INTERNAL MEDICINE CAIN, PENNY P, NP 112 SAINT JOHN ST (318) OLIVER RD WAITING AREA L (318) PEDIATRICS CARR, VIVIAN S, NP 3401 MAGNOLIA CV MONROE, LA (318) DUCKWORTH-HOWARD, APRIL, NP 920 OLIVER RD WAITING AREA K (318) WEBB, STACY D, NP 3401 MAGNOLIA COVE MONROE, LA (318) MEDICAL PARK DR MONROE, LA (318) SPECIALISTS OBSTETRICIAN AND GYNECOLOGIST REID, LINDA F, NP 2913 DESIARD ST (318) BETIN AVE (318) S 2ND ST MONROE, LA (318) at any time. Please call (318) or go to to verify provider status. Page 12

15 REGION 4 Includes Beauregard, Allen, Calcasieu, Cameron, and Jefferson Davis Parishes. MEDICAL HOME - PCP's FAMILY PRACTICE BAROOTES, BRYAN G, 1525 OAK PARK BLVD (337) REGION 5 Includes Evangeline, Acadia, Vermilion, Lafayette, St. Mary, Terrebonne, St. Landry, Iberia and St. Martin Parishes. MEDICAL HOME - PCP's FAMILY PRACTICE MARSHALL, MARILYN D, 806 JEFFERSON TERRACE BLVD NEW IBERIA, LA (337) WEST CONGRESS (337) MENARD, DARRIN, 202 WESTGATE RD (337) MIRE, GEOFFREY A, 202 WESTGATE ST (337) RAMSEY, KEITH G, 806 JEFFERSON TERRACE BLVD NEW IBERIA, LA (337) CHARITY ST ABBEVILLE, LA (337) REGION 6 Includes Livingston, Assumption, West Feliciana, East Feliciana, Iberville, St. Helena, St. James, East Baton Rouge, West Baton Rouge, Pointe Coupee and Ascension Parishes. MEDICAL HOME - PCP's INTERNAL MEDICINE MCKNIGHT, GEORGE T, JACKSON ST CLINTON, LA (225) ALLENDALE DR PORT ALLEN, LA (225) NON-PHYSICIAN PRACTITIONERS FAMILY PRACTICE BLACKMON, BETTIE T, NP JACKSON ST CLINTON, LA (225) CONNELL, KRISTA, NP 3619 HWY 10 JACKSON, LA (225) DART JR, WILLIAM D, NP 5439 AIRLINE HWY BATON ROUGE, LA (225) JACKSON ST CLINTON, LA (225) ODONOVAN BLVD STE 404 WALKER, LA (225) DILLARD, JUSTIN J, NP SHOE CREEK DR BATON ROUGE, LA (225) JACKSON ST CLINTON, LA (225) ESTERS, TANISHA, NP WAGLEY RD MARINGOUIN, LA (225) FORDOCHE RD STE A LIVONIA, LA (225) NEWFIELD DR LIVONIA, LA (225) ROBERTS DR NEW ROADS, LA (225) POINTE COUPEE RD NEW ROADS, LA (225) GILLIAM, DARIE S, NP JACKSON ST CLINTON, LA (225) GUILLOT, MARY L, NP JACKSON ST CLINTON, LA (225) HWY 42 SPRINGFIELD, LA (225) HANEY, AHLECIA, NP 6450 LA HWY 1 BATCHELOR, LA (225) HORNBOSTEL BAKER, JUDY, NP JACKSON ST CLINTON, LA (225) HUNT, GINGER A, NP JACKSON ST CLINTON, LA (225) JOHNSON, MEREDITH, NP 203 ALLENDALE DR PORT ALLEN, LA (225) MARTIN DUHE, MONTRELL, NP 230 ROBERTS DR NEW ROADS, LA (225) ROBERTS DR STE H NEW ROADS, LA (225) ROSCOE, NARKITA W, NP 3140 FLORIDA ST (225) THOMAS, LAKESHA T, NP 1104 W HWY 30 (225) ESSEN LANE STE 300 (225) RIVER WEST DR STE A&B PLAQUEMINE, LA (225) O'DONOVAN BLVD STE 507 WALKER, LA LA HWY 1 SOUTH PORT ALLEN, LA GENERAL PRACTICE SMITH, TAMMY D, NP 490 SITMAN ST GREENSBURG, LA (225) PEDIATRICS MILES, DARAKA Y, NP 6351 MAIN ST ZACHARY, LA (888) ST ROMAIN, JENNIFER F, NP OLD BATON ROUGE HWY ALBANY, LA (225) SPECIALISTS INFECTIOUS DISEASES CAMPBELL JR, WALTER L, 3140 FLORIDA BLVD (225) REGION 7 Includes Tangipahoa, LaFourche, St. Charles, St. John the Baptist, St. Tammany, Plaquemines, Jefferson, Orleans, Washington and St. Bernard Parishes. MEDICAL HOME - PCP's FAMILY PRACTICE ANDERSON, DANITA C, 3201 S CARROLLTON AVE (504) at any time. Please call (318) or go to to verify provider status. Page 13

16 100 WARRINGTON DR STE B NEW ORLEANS, LA (504) READ BLVD NEW ORLEANS, LA (504) IMSAIS, KHALIL Y, 1020 ST ANDREW ST NEW ORLEANS, LA (504) LAGARDE MAY, MICHELE T, 100 WARRINGTON DR NEW ORLEANS, LA (504) WARRIER, JAYA S, 3932 US HWY 90 WESTWEGO, LA (504) WILLIAMS, DAVE E, 111 N CAUSEWAY BLVD (504) GENERAL PRACTICE NANJAPPA, NAGARAJ, OLD BATON ROUGE HWY (225) INTERNAL MEDICINE ABELL, MARY M, 1936 MAGAZINE STREET NEW ORLEANS, LA (504) CENTANNI, EVA B, 3201 S CARROLTON AVE STE B (504) DUMAS, JEREMY G, 5140 CHURCH ST LAFITTE, LA (504) LAPALCO BLVD (504) US HWY 90 AVONDALE, LA (504) FRANCIONI, SCOTT M, 1020 ST ANDREW ST NEW ORLEANS, LA (504) GRANT SPENCER, TELITHA, 2405 JACKSON AVE NEW ORLEANS, LA (504) ST BERNARD AVE NEW ORLEANS, LA (504) ST ANDREW ST NEW ORLEANS, LA (504) MAGAZINE ST NEW ORLEANS, LA (504) GREENE, STACY, 1020 ST ANDREW ST NEW ORLEANS, LA (504) KAUTZMAN, MICHELE G, 5140 CHURCH ST LAFITTE, LA (504) LAPALCO BLVD (504) LEVI, TANIA A, 1980 NORTH HWY 190 (985) URBIZO, CAROLINA, 3201 S CARROLTON AVE STE B (504) WINFREY, KEITH L, CHEF MENTEUR HWY NEW ORLEANS, LA (504) PEDIATRICS BEVROTTE, LOUIS H, 5630 READ BLVD NEW ORLEANS, LA (504) DAL CORSO, MARK, 200 HENRY CLAY AVE (504) S CARROLLTON AVE (504) POREE TURNER, CECILY J, 298 HENRY CLAY AVE (504) S CARROLLTON AVE (504) NON-PHYSICIAN PRACTITIONERS FAMILY PRACTICE COLLINS, LYNETTE D, NP 1030 LESSEPS ST NEW ORLEANS, LA (504) DARENSBOURG, SARA P, NP 111 N CAUSEWAY BLVD (504) S CARROLLTON AVE (504) READ BLVD NEW ORLEANS, LA (504) DUPLANTIER, DIONNE R, NP 1020 ST ANDREW ST NEW ORLEANS, LA (504) GEHRING, VANESSA N, NP CHEF MENTEUR HWY NEW ORLEANS, LA (504) GRIFFIN, NICOLE C, NP 3943 ST BERNARD AVE NEW ORLEANS, LA (504) TULANE AVE NEW ORLEANS, LA (504) HOWARD, KRYSTAL, NP 111 N CAUSEWAY BLVD (504) S CARROLLTON AVE (504) READ BLVD NEW ORLEANS, LA (504) JOHNSON, WINIFRED E, NP 1020 ST ANDREW ST NEW ORLEANS, LA (504) MORNAY, YOLONDA R, NP 5630 READ BLVD NEW ORLEANS, LA (504) THERIAULT, TANYA A, NP 111 N CAUSEWAY BLVD (504) N CAUSEWAY BLVD (504) S CARROLLTON AVE (504) READ BLVD NEW ORLEANS, LA (504) WALLIN, MIA J, NP 2405 JACKSON AVE NEW ORLEANS, LA (504) ST BERNARD AVE NEW ORLEANS, LA (504) ST ANDREW ST NEW ORLEANS, LA (504) MAGAZINE ST NEW ORLEANS, LA (504) GENERAL PRACTICE AGE, CHANIEL, NP 1020 ST ANDREW ST NEW ORLEANS, LA (504) PEARL, NIKITA, NP 721 AVENUE G KENTWOOD, LA (225) INTERNAL MEDICINE MCNEIL, VONDER W, NP 7017 LAPALCO BLVD (504) US 90 AVONDALE, LA (504) PEDIATRICS SIMONEAUX, KIMBERLY, NP 721 AVENUE G KENTWOOD, LA (225) ST ROMAIN, JENNIFER F, NP BERRY BOWL RD. INDEPENDENCE, LA (888) at any time. Please call (318) or go to to verify provider status. Page 14

17 721 AVE G KENTWOOD, LA (225) SPECIALISTS INFECTIOUS DISEASES FUGATE, TOBY L, DO 2601 TULANE AVE STE 500 NEW ORLEANS, LA (504) MURPHY, MARY J, 2601 TULANE AVE STE 500 NEW ORLEANS, LA (504) WILCOX, RONALD D, 2601 TULANE AVE STE 500 NEW ORLEANS, LA (504) at any time. Please call (318) or go to to verify provider status. Page 15

18 Tier 1 Provider Network Members seeing Tier 1 providers pay the Deductible (if applicable), Copayments and Co-insurance as described in the Tier 1 In-Network column in the Certificate of Coverage and/or the Cost Share Schedule. Tier 1 Providers cannot balance bill the Member. Page 16

19 HOSPITALS ACADIA ST LANDRY PARISH HOSPITAL 810 SOUTH BROADWAY CHURCH POINT, LA (337) ALLEN PARISH HOSPITAL 108 6TH AVE KINDER, LA (337) ASHLEY COUNTY MEDICAL CENTER 1015 UNITY RD CROSSETT, AR (870) ASSUMPTION COMMUNITY HOSPITAL 135 HWY 402 NAPOLEONVILLE, LA (985) AVOYELLES HOSPITAL 4231 HWY 1192 MARKSVILLE, LA (318) BATON ROUGE GENERAL MEDICAL CENTER 3600 FLORIDA BLVD (225) PICARDY AVE (504) BEAUREGARD MEMORIAL HOSPITAL 600 S PINE ST DERIDDER, LA (337) BIENVILLE MEDICAL CENTER LLC 1175 PINE ST STE 200 ARCADIA, LA (318) BRADLEY COUNTY MEDICAL CENTER 404 S BRADLEY ST WARREN, AR (870) BRFHH MONROE LLC DBA UNIVERSITY HEALTH CONWAY 4864 JACKSON ST MONROE, LA (318) BRFHH SHREVEPORT LLC DBA UNIVERSITY HEALTH SHREVEPORT 1541 KINGS HWY SHREVEPORT, LA (318) BUNKIE GENERAL HOSPITAL 427 EVERGREEN ST BUNKIE, LA (318) BYRD REGIONAL HOSPITAL 1020 W FERTITTA BLVD LEESVILLE, LA (337) CALDWELL MEMORIAL HOSPITAL 411 MAIN ST COLUMBIA, LA (318) CENTRAL LA SURGICAL HOSPITAL LLC 651 NORTH BOLTON AVE (318) CHRISTUS COUSHATTA HEALTH CARE CENTER 1635 MARVEL ST COUSHATTA, LA (318) CHRISTUS LAKE AREA HOSPITAL 4200 NELSON RD LAKE CHARLES, LA (337) CHRISTUS SAINT FRANCES CABRINI HOSPITAL 3330 MASONIC DR (318) CHRISTUS SCHUMPERT HIGHLAND 2531 VIKING DR (318) EAST BERT KOUNS (318) CHRISTUS ST PATRICK HOSPITAL 524 DR MICHAEL DEBAKEY DR (337) CITIZENS MEDICAL CENTER 7939 HWY 165 COLUMBIA, LA (318) CYPRESS POINTE SURGICAL HOSPITAL SOUTH AIRPORT RD (985) DALLAS COUNTY MEDICAL CENTER 201 N CLIFTON FORDYCE, AR (870) DEQUINCY MEMORIAL HOSPITAL 110 W 4TH ST DEQUINCY, LA (337) DESOTO REGIONAL HEALTH SYSTEM 207 JEFFERSON ST MANSFIELD, LA (318) DOCTORS HOSPITAL AT DEER CREEK 815 S TENTH ST LEESVILLE, LA (337) EAST CARROLL PARISH HOSPITAL 336 N HOOD ST LAKE PROVIDENCE, LA (318) EAST JEFFERSON GENERAL HOSPITAL 4200 HOUMA BLVD (504) FAIRWAY MEDICAL CENTER INDUSTRY LN (985) FRANKLIN FOUNDATION HOSPITAL 1097 NORTHWEST BLVD FRANKLIN, LA (337) FRANKLIN MEDICAL CENTER 2106 LOOP RD WINNSBORO, LA (318) GARDEN PARK MEDICAL CENTER COMMUNITY RD GULFPORT, MS (228) HARDTNER MEDICAL CENTER 1102 NORTH PINE RD OLLA, LA (318) HEART HOSPITAL OF ACADIANA OF LAFAYETTE 1105 KALISTE SALOOM RD (337) HOMER MEMORIAL HOSPITAL DBA CLAIBORNE MEDICAL CTR 620 EAST COLLEGE DR HOMER, LA (318) HOOD MEMORIAL HOSPITAL 301 WEST WALNUT ST AMITE, LA (985) HOWARD MEMORIAL HOSPITAL 130 MEDICAL CIR NASHVILLE, AR (870) IASIS GLENWOOD REGIONAL MEDICAL CENTER 1275 GLENWOOD DR (318) MCMILLAN RD (318) IBERIA MEDICAL CENTER 2315 E MAIN ST NEW IBERIA, LA (337) JACKSON PARISH HOSPITAL 165 BEECH SPRINGS RD JONESBORO, LA (318) JENNINGS AMERICAN LEGION HOSPITAL 1636 ELTON RD JENNINGS, LA (337) KINGS DAUGHTERS MEDICAL CENTER 427 HWY 51 NORTH BROOKHAVEN, MS (601) LAFAYETTE SURGICAL SPECIALTY HOSPITAL 1101 KALISTE SALOOM RD (337) KALISTE SALOOM RD (337) LAKE CHARLES MEMORIAL HOSPITAL 1701 OAK PARK BLVD (337) at any time. Please call (318) or go to to verify provider status. Page 17

20 1900 GAUTHIER RD LAKE CHARLES, LA (337) LAKE SURG HOSP SLIDELL DBA SOUTHERN SURGICAL HOSPITAL 1700 W LINDBERG DR (985) LALLIE KEMP MEDICAL CENTER HWY 51 SOUTH INDEPENDENCE, LA (985) LASALLE GENERAL HOSPITAL 187 NINTH ST JENA, LA (318) MADISON PARISH HOSPITAL 900 JOHNSON ST TALLULAH, LA (318) MEDICAL CENTER OF SOUTH ARKANSAS 700 W GROVE EL DORADO, AR (870) MENA REGIONAL HEALTH SYSTEM 311 N MORROW ST MENA, AR (479) MERCY REGIONAL MEDICAL CENTER 800 E MAIN ST VILLE PLATTE, LA (337) US HWY 190 EUNICE, LA (337) MERIT HEALTH NATCHEZ 54 SEARGENT S PRENTISS DR NATCHEZ, MS (601) MINDEN MEDICAL CENTER 1 MEDICAL PLAZA MINDEN, LA (318) MONROE SURGICAL HOSPITAL 2408 BROADMOOR BLVD (318) MOREHOUSE GENERAL HOSPITAL 323 WEST WALNUT BASTROP, LA (318) NATCHITOCHES REGIONAL MEDICAL CENTER 501 KEYSER AVE NATCHITOCHES, LA (318) NEW ORLEANS EAST HOSPITAL 5620 READ BLVD NEW ORLEANS, LA (504) NORTH CADDO MEDICAL CENTER 1000 SOUTH SPRUCE ST VIVIAN, LA (318) NORTHERN LOUISIANA MEDICAL CENTER 1118 S FARMERVILLE ST (318) EAST VAUGHN AVE (318) OAKDALE COMMUNITY HOSPITAL 130 N HOSPITAL DR OAKDALE, LA (318) OUR LADY OF LOURDES REGIONAL MEDICAL CENTER 4801 AMBASSADOR CAFFERY PKWY (337) OUR LADY OF THE ANGELS HOSPITAL INC 433 PLAZA ST BOGALUSA, LA (985) OUR LADY OF THE LAKE RMC 5000 HENNESSY BLVD (225) P&S SURGICAL HOSPITAL 312 GRAMMONT ST (318) PARK PLACE SURGICAL HOSPITAL 4811 AMBASSADOR CAFF PKWY (337) PHYSICIANS MEDICAL CENTER 218 CORPORATE DR (985) POINTE COUPEE GENERAL HOSPITAL 2202 FALSE RIVER DR NEW ROADS, LA (225) PREVOST MEMORIAL HOSPITAL 301 MEMORIAL DR DONALDSONVILLE, LA (225) RAPIDES REGIONAL MEDICAL CENTER 211 4TH ST (318) REEVES MEMORIAL MEDICAL HOSPITAL 409 FIRST ST BERNICE, LA (318) RICHLAND PARISH HOSPITAL 407 CINCINNATI ST DELHI, LA (318) RICHLAND PARISH HOSPITAL SERVICE DBA RICHARDSON MEDICAL CTR 256 HIGHWAY 3048 RAYVILLE, LA (318) RIVERLAND MEDICAL CENTER 1700 EE WALLACE BLVD FERRIDAY, LA (318) RIVERSIDE MEDICAL CENTER 1900 SOUTH MAIN ST FRANKLINTON, LA (985) SABINE MEDICAL CENTER 240 HIGHLAND DR MANY, LA (318) SAINT CHARLES PARISH HOSPITAL 1057 PAUL MAILLARD RD LULING, LA (985) SAINT FRANCIS MEDICAL CENTER 309 JACKSON ST (318) SLIDELL MEMORIAL HOSPITAL 1001 GAUSE BLVD (985) FLORIDA AVE (985) ROBERT BLVD (985) GAUSE BLVD (985) SOUTH CAMERON MEMORIAL HOSPITAL 5360 WEST CREOLE HWY CAMERON, LA (337) SPECIALISTS HOSPITAL SHREVEPORT 1500 LINE AVE SHREVEPORT, LA (318) SPRINGHILL MEDICAL CENTER 2001 DOCTORS DR SPRINGHILL, LA (318) ST BERNARD PARISH HOSPITAL 8000 W JUDGE PEREZ HWY CHALMETTE, LA (504) ST ELIZABETH HOSPITAL 1125 W HWY 30 (225) ST HELENA PARISH HOSPITAL HWY 43 GREENSBURG, LA (225) ST JAMES PARISH HOSPITAL 1645 LUTCHER AVE LUTCHER, LA (225) SURGICAL SPECIALTY CENTER OF BATON ROUGE 8080 BLUEBONNET BLVD BATON ROUGE, LA (225) TECHE REGIONAL MEDICAL CENTER 1125 MARGUERITE ST MORGAN CITY, LA (985) TOURO INFIRMARY 1401 FOUCHER ST 1ST FLOOR (504) at any time. Please call (318) or go to to verify provider status. Page 18

21 TULANE MEDICAL CENTER 4700 S I-10 SERVICE RD E (504) REFERRAL CENTERS/ PHYSICIANS with Prior Plan Approval ATKINS, LOGAN, 2104 C LOOP RD WINNSBORO, LA (318) CALHOUN, B KEITH, 4400 OLD STERLINGTON RD MONROE, LA (318) TULANE AVE (504) JUDGE TANNER BLVD (985) UNION GENERAL HOSPITAL 901 JAMES AVE FARMERVILLE, LA (318) UNIVERSITY MEDICAL CTR NEW ORLEANS DBA UNIV MED CTR MGT CORP 2000 CANAL ST (504) WEST CALCASIEU CAMERON HOSPITAL 701 CYPRESS ST SULPHUR, LA (337) WEST CARROLL HEALTH SYSTEMS 706 ROSS ST OAK GROVE, LA (318) WEST FELICIANA PARISH HOSPITAL 5266 COMMERCE ST SAINT FRANCISVILLE, LA (225) WEST JEFFERSON MEDICAL CENTER 1101 MEDICAL CENTER BLVD (504) WINN PARISH MEDICAL CENTER 301 WEST BOUNDARY WINNFIELD, LA (318) WOMANS HOSPITAL 100 WOMANS WAY BATON ROUGE, LA (225) WOMENS & CHILDRENS HOSPITAL 4600 AMBASSADOR CAFFREY (337) ARKANSAS CHILDRENS HOSPITAL 1 CHILDRENS WAY LITTLE ROCK, AR (501) CHILDRENS HOSPITAL 200 HENRY CLAY AVE (504) M D ANDERSON CANCER CENTER 1515 HOLCOMB BLVD HOUSTON, TX (713) SAINT JUDE CHILDRENS RESEARCH HOSPITAL 262 DANNY THOMAS PL MEMPHIS, TN (866) SHRINERS HOSPITALS FOR CHILDREN 3100 SAMFORD AVE SHREVEPORT, LA (318) UAB HOSPITAL TH AVE SOUTH BIRMINGHAM, AL (205) REGION 1 Includes Ouachita, Lincoln, Morehouse, Union, Richland, East Carroll, West Carroll, Madison, Jackson, Caldwell, Franklin, Tensas and Winn Parishes. MEDICAL HOME - PCP's FAMILY PRACTICE ABRAHAM, RALPH L, 115 CHRISTIAN DR RAYVILLE, LA (318) ALEXANDER, WILLIAM C, 503 MCMILLAN RD (Hospitalist/Intensivist) ANDERS, KERRY L, 3400 MEDICAL PARK DR STE A MONROE, LA (318) HWY 17 WINNSBORO, LA (318) VERONA ST NEWELLTON, LA (318) NEWTON ST SAINT JOSEPH, LA (318) BAILEY, DON W, 300 SCARBROUGH LAKE PROVIDENCE, LA (318) BAINES, JOHNATHAN, 1200 SOUTH FARMERVILLE ST (318) NORTHPOINTE LN STE 102 (318) BALL JR, JAMES E, 1962 JULIA ST RAYVILLE, LA (318) BANKS III, TOMMY G, 1900 NORTH 7TH ST (318) BARNES, DAVID L, 3400 MEDICAL PARK DR STE C MONROE, LA (318) BEEBE, WILLIAM E, 503 MCMILLIAN RD (318) BELUE, JAMES MICHAEL, 707 SOUTH VIENNA ST (318) BREARD, ERIN R, 3995 STERLINGTON RD STE A MONROE, LA (318) NTH 7TH ST (318) CARLISLE, KEVIN M, 256 HWY 3048 RAYVILLE, LA (318) HWY 80 RAYVILLE, LA (318) COATS, JOHN M, 327 W HICKORY AVE BASTROP, LA (318) COLEMAN, EDWARD O, DO 109 REGENCY PLACE (318) COLVIN, THOMAS L, 2106 LOOP RD STE A WINNSBORO, LA (318) COMBETTA, JEFFREY J, 2104 LOOP RD STE C WINNSBORO, LA (318) CONVILLE, STACY D, 103 WATTS ST STE 101 JONESBORO, LA (318) COTTER, MARK M, 2104C LOOP RD WINNSBORO, LA (318) COUGHRAN, JIMMY R, 1010 DAVIS LAKE RD COLUMBIA, LA (318) FAIR AVE WINNSBORO, LA (318) COX JR, CARTER, 206 S VINE ST BASTROP, LA (318) CROUCH, REBECCA L, 166 BEECH SPRINGS RD JONESBORO, LA (318) CUMMINGS, RUSSELL O, 484 COLLINS RD COLUMBIA, LA (318) at any time. Please call (318) or go to to verify provider status. Page 19

22 DANSBY JR, THOMAS, 100 SOUTH SECOND ST (318) GARCIA, ROBERT L, 503 MCMILLAN RD (318) HEARN, PAMELA R, 402 SECOND ST BERNICE, LA (318) KUTNIKAR, DHAYA N, 1805 LAMY LN (318) DOLLAR, CINDY F, 503 MCMILLAN RD (318) DOLLAR, MARK F, 1900 N 7 TH ST (318) DOMINGUE, CHRISTOPHER M, 708 EAST MAIN ST OAK GROVE, LA (318) GHANTA, SUMATHA, 920 OLIVER RD (318) GIVLER JR, DONALD N, 503 MCMILLAN RD (318) (Hospitalist/Intensivist) GIVLER, AMY M, 2933 CYPRESS ST STE 1 (318) HENRY, JOE BYRON, 3995 STERLINGTON RD STE A MONROE, LA (318) N 7TH ST (318) HERBERT, ALLEN J, 411 E VAUGHN AVE STE 203 (318) LAMME, ROBERT K, 503 MCMILLAN (936) (Hospitalist/Intensivist) LAPITE, OLADAPO, 306 STONE AVE (318) LE, DUNG N, 508 BROADWAY DELHI, LA (318) DUPREE, ERIC C, 639 W LAFAYETTE ST WINNFIELD, LA (318) ELDRIDGE, JOEL G, DO 2104-C LOOD RD WINNSBORO, LA (318) LOOP RD WINNSBORO, LA (318) ELLIOTT, CLYDE E, 200 PROFESSIONAL DR (318) ENRIQUEZ, JOSE R, 508 BROADWAY ST DELHI, LA (318) ENSMINGER, BOBBY T, 1200 CELEBRITY DR STE 3 (318) JACKSON ST (318) EPPINETTE, JAMES M, 309 JACKSON ST (318) (Hospitalist/Intensivist) 5328 CYPRESS ST (318) FRENGELL, NILGUN CAMILLA, 309 JACKSON ST (318) (Hospitalist/Intensivist) GONZALES, CESAR Z, 407 CINCINNATI ST DELHI, LA (318) BROADWAY ST DELHI, LA (318) ELM ST DELHI, LA (318) GREEN, GREGORY R, 920 OLIVER RD WAITING AREA M (318) GRIGSBY, BENSON A, 2916 N TRENTON ST (318) S BONNER ST RUSTON, LA (318) GUINIGUNDO, NOLI, 502 ROSS ST OAK GROVE, LA (318) GUJJULA, RAJESH, 920 OLIVER RD WAITING AREA J (318) HARRIS, R BRIAN, 402 SECOND ST BERNICE, LA (318) HAYWARD SR, MICHAEL T, 3400 MEDICAL PARK STE B MONROE, LA (318) HORNE, STEPHEN K, 503 MCMILLAN RD (318) (Hospitalist/Intensivist) IGLESIAS, JULIO E, 301 A WEST BOUNDARY WINNFIELD, LA (318) ISLAM, NAHID A, 2600 TOWER DR STE 106 (318) IZE IYAMU, MENONI, 407 CINCINNATI ST DELHI, LA (318) JETHA, TEJAL, 309 JACKSON ST (318) (Hospitalist/Intensivist) JONES, TAMMY V, DO 4864 JACKSON ST MONROE, LA (318) KERR, ALBERT G, 121 CHRISTIAN DR RAYVILLE, LA (318) KOVAC, KAY B, 300 SCARBROUGH ST LAKE PROVIDENCE, LA (318) KRIER, BRIAN P, 1201 FAIRVIEW AVE (318) ELM ST DELHI, LA (318) MARQUARDT, AARON L, 1801 N 7TH ST STE A (318) MASSENGALE, GORDON B, 111 CHRISTIAN DR RAYVILLE, LA (318) MCDONALD III, KENNETH E, 508 BROADWAY ST DELHI, LA (318) MCMAHAN, STEVEN H, 1117 CHENIERE DREW RD (318) N 7TH ST (318) MELTON, STUART L, 920 OLIVER RD WAITING AREA J (318) METOYER JR, KENNETH P, 1200 S FARMERVILLE ST (318) MEYERS, OWEN M, 920 OLIVER RD WAITING AREA M (318) at any time. Please call (318) or go to to verify provider status. Page 20