Provider Demographics
NPI:1740602572
Name:BRIAN H. STRAND, M.D., A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:BRIAN H. STRAND, M.D., A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:STRAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-626-6277
Mailing Address - Street 1:200 GREENLEAVES BLVD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-7092
Mailing Address - Country:US
Mailing Address - Phone:985-626-6277
Mailing Address - Fax:985-626-6209
Practice Address - Street 1:200 GREENLEAVES BLVD
Practice Address - Street 2:SUITE 11
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-7092
Practice Address - Country:US
Practice Address - Phone:985-626-6277
Practice Address - Fax:985-626-6209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09430R207YS0123X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty