LANDON TAYLOR ERICKSTAD (NPI# 1457642282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457642282 |
| Entity Type | Individual |
| Full Name | LANDON TAYLOR ERICKSTAD |
| Credential | MD |
| Practice Address |
802 Medical Dr Ste 400 Longview TX 75605-5205 |
| Mailing Address |
Po Box 847176 Dallas TX 75284-7176 |
| Practice Telephone | 9037577871 |
| Practice Fax Number | 9037532479 |
| Mailing Telephone | 9032371800 |
| Mailing Fax Number | 9032371810 |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2016-08-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Q8053 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
802 MEDICAL DR STE 400 |
| City | LONGVIEW |
| State | TX |
| Zip Code | 75605-5205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194353730 | Dusty Rae Hane | Nurse Practitioner | Diagnostic Clinic of Longview, 2901 N Fourth St, Longview, TX 75605 | 2020-03-30 |
| 1831720374 | Kaycee Whatley | Nurse Practitioner | 323 W Hawkins Parkway, Longview, TX 75605 | 2020-02-03 |
| 1245733492 | Somers Pediatrics | Pediatrics | 103 W. Loop 281, Suite 474, Longview, TX 75605 | 2018-03-14 |
| 1467838391 | Piney Woods Er II LLC | Clinic/Center | 120 East Loop 281, Longview, TX 75605 | 2015-08-03 |
| 1386023968 | Elizabeth Ann Heeb Tidwell | Obstetrics & Gynecology | 802 Medical Dr Ste 100, Longview, TX 75605 | 2015-05-28 |
| 1215353651 | Tracy Hicks | Nurse Practitioner | 102 Commander Dr Ste 9, Longview, TX 75605 | 2014-03-10 |
| 1073881280 | Deirdre Scotter | Specialist/Technologist | 201 E Tomlinson Pkwy, Longview, TX 75605 | 2011-12-02 |
| 1316230139 | Traditions Hospice of Longview, LLC | Hospice Care, Community Based | 4362 N Us Hwy 259, Suite B, Longview, TX 75605 | 2011-05-26 |
| 1184916769 | Telema Dikibujiri Nga | Pediatrics | Longview Regional Medical Center, 2901 North Fourth Street, Longview, TX 75605 | 2011-05-13 |
| 1902101108 | The Veta Lewis Behavioral Health Group | Counselor | 1800 S. Judson St., Suite 100, Longview, TX 75605 | 2011-01-19 |
| Find all providers in zip 75605 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649780453 | Paul Bradley Md Pllc | Urology | 703 E Marshall Ave Ste 4009, Longview, TX 75601-5500 | 2017-10-06 |
| 1639207574 | Gid Roger Johnson | Urology | 1608 Sweetbriar St, Longview, TX 75604-2654 | 2007-03-01 |
| 1780658112 | Robert W Frederick | Urology | 703 E Marshall Ave Ste 5007, Longview, TX 75601 | 2006-02-14 |
| 1285632919 | Patrick M Lassen | Urology | 625 9th Ave, Suite 120, Longview, WA 98632-2464 | 2005-07-07 |
| 1932369832 | Paul R Bradley | Urology | 703 E Marshall Ave, Suite 5007, Longview, TX 75601-5500 | 2008-06-13 |
| 1346430527 | Adrienne J K Carmack | Urology | 703 E Marshall Ave, Suite 5007, Longview, TX 75601-5500 | 2007-07-25 |
| 1790847994 | M'liss A Hudson | Urology | 802 Medical Dr, Suite 400, Longview, TX 75605-5100 | 2006-12-14 |
| 1588688402 | John Thomas Mansfield | Urology | 625 9th Ave, Suite 120, Longview, WA 98632-2464 | 2006-07-26 |
| 1700853793 | Gregory A Edwards | Urology | 802 Medical Dr, Suite 400, Longview, TX 75605-5100 | 2006-03-08 |
| 1588631576 | John M Ferrell | Urology | 703 E Marshall Ave, Suite 5008, Longview, TX 75601-5500 | 2006-03-08 |
| Find all providers in LONGVIEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.