Champagne, Bradley Paul
Champagne, Bradley Paul is an sole proprietor health care provider with primary practice located at 102 Drury Ln , Lafayette LA 70508-5702. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Champagne, Bradley Paul can be contacted via phone (337) 233-0219.Contact Information
Primary practice address
102 Drury Ln
Lafayette LA 70508-5702
Phone: (337) 233-0219
Fax: (337) 233-2418
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 206155 | Louisiana |
Profile Details
| NPI number | 1578858288 |
|---|---|
| LBN Legal business name | Champagne, Bradley Paul |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 10th, 2011 |
| Last updated | Oct 18th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578858288 | NPPES |
| Other | 600535AI32 | MEDICARE | |
| MEDICAID | 2147846 | MEDICARE | |
| MEDICAID | INTERN | MEDICARE |
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