Provider Demographics
NPI:1639330368
Name:BERT R. BRATTON APMC
Entity Type:Organization
Organization Name:BERT R. BRATTON APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-646-2303
Mailing Address - Street 1:985 ROBERT BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2063
Mailing Address - Country:US
Mailing Address - Phone:985-646-2303
Mailing Address - Fax:985-690-8334
Practice Address - Street 1:985 ROBERT BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2063
Practice Address - Country:US
Practice Address - Phone:985-646-2303
Practice Address - Fax:985-690-8334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011991207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty