Provider Demographics
NPI:1083610729
Name:GASPARD, BRAD J (MD)
Entity Type:Individual
Prefix:
First Name:BRAD
Middle Name:J
Last Name:GASPARD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8490 PICARDY AVE
Mailing Address - Street 2:BLDG 200
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3731
Mailing Address - Country:US
Mailing Address - Phone:225-237-1754
Mailing Address - Fax:225-237-1722
Practice Address - Street 1:8595 PICARDY AVE
Practice Address - Street 2:STE 100
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3674
Practice Address - Country:US
Practice Address - Phone:225-763-4900
Practice Address - Fax:225-763-4938
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2014-09-23
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Provider Licenses
StateLicense IDTaxonomies
LA13873R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1180807Medicaid
LA080183336OtherRAILROAD MEDICARE
LA4A371B116Medicare PIN
LA1180807Medicaid