Doctor Name: | DR. BRYAN CLARK MCCANN |
NPI Number: | 1548218969 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 11407 |
Business Practice Address: | 424 North Washington St Marksville, LA - 71351 |
Business Phone Number: | 3182538136 |
Business Fax Number: | 3182535198 |
Mailing Address: | 424 North Washington St, MARKSVILLE |
State: | LA |
Postal Code: | 71351 |
Phone Number: | 3182538136 |
Fax Number: | 3182535198 |
NPI Enumeration Date: | 05/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 11407 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |