Charlie H Bridges Md, Facs | |
7777 Hennessy Blvd Ste 608 Baton Rouge LA 70808-4366 | |
(225) 767-0394 | |
(225) 767-3904 |
Full Name | Charlie H Bridges Md, Facs |
---|---|
Speciality | Clinic/Center |
Location | 7777 Hennessy Blvd Ste 608, Baton Rouge, Louisiana |
Authorized Official Name and Position | Charlie H Bridges (OWNER) |
Authorized Official Contact | 2257670394 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Charlie H Bridges Md, Facs 7777 Hennessy Blvd Ste 608 Baton Rouge LA 70808-4366 Ph: (225) 767-0394 | Charlie H Bridges Md, Facs 7777 Hennessy Blvd Ste 608 Baton Rouge LA 70808-4366 Ph: (225) 767-0394 |
NPI Number | 1003135633 |
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Provider Enumeration Date | 05/21/2010 |
Last Update Date | 06/12/2014 |
Medicare PECOS PAC ID | 0143351577 |
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Medicare Enrollment ID | O20100629000838 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003135633 | NPI | - | NPPES |
1370339 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 07141R (Louisiana) | Primary |
Provider Name | Charlie H Bridges |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1457386310 PECOS PAC ID: 8123159555 Enrollment ID: I20100629000867 |
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