Provider Demographics
NPI:1932291838
Name:MARCH, BROOKMAN GEORGE
Entity Type:Individual
Prefix:MR
First Name:BROOKMAN
Middle Name:GEORGE
Last Name:MARCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 S ACADIAN THRUWAY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6900
Mailing Address - Country:US
Mailing Address - Phone:225-387-0010
Mailing Address - Fax:225-387-0013
Practice Address - Street 1:1200 S ACADIAN THRUWAY
Practice Address - Street 2:SUITE 105
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6900
Practice Address - Country:US
Practice Address - Phone:225-387-0010
Practice Address - Fax:225-387-0013
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies