Provider Demographics
NPI:1225701832
Name:JOHN BRIAN MD LLC
Entity Type:Organization
Organization Name:JOHN BRIAN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-623-3534
Mailing Address - Street 1:220 SAINT ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-9721
Mailing Address - Country:US
Mailing Address - Phone:318-623-3534
Mailing Address - Fax:
Practice Address - Street 1:104 N 3RD ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8581
Practice Address - Country:US
Practice Address - Phone:318-449-1370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty