Mcdonald, Brenton Wayne

Mcdonald, Brenton Wayne is an individual health care provider with primary practice located at 2807 Evangeline St , Monroe LA 71201-3749. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mcdonald, Brenton Wayne can be contacted via phone (318) 737-2269.

Contact Information

Primary practice address
2807 Evangeline St Monroe LA 71201-3749
Phone: (318) 737-2269
Fax: (318) 324-1719
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 12051R Louisiana

Profile Details

NPI number 1528094455
LBN Legal business name Mcdonald, Brenton Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Dec 11th, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528094455 NPPES
Louisiana MEDICAID 1542288
Louisiana Other 134436001
Louisiana Other 300101532

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