Provider Demographics
NPI:1437200045
Name:BRAUD, JOSEPH PIERCE SR (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PIERCE
Last Name:BRAUD
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13826
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70185
Mailing Address - Country:US
Mailing Address - Phone:504-214-1035
Mailing Address - Fax:
Practice Address - Street 1:101 WILBOURNE BLVD
Practice Address - Street 2:801
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506
Practice Address - Country:US
Practice Address - Phone:337-234-1018
Practice Address - Fax:337-234-1024
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1895R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA03049Medicaid
5J083Medicare ID - Type Unspecified
LA03049Medicaid