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NPI Code Detail

MEDICARE: VINCENT BRYAN LOCOCO MD

MEDICARE: VINCENT BRYAN LOCOCO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician021984LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093745648
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINCENT BRYAN LOCOCO MD
Provider Business Mailing Address
First Line : 106 TRI STATE DR
Second Line :
City : SAREPTA
State : LA
Zip : 71071-2826
Country : US
Telephone Number : 318-994-2266
Fax Number : 318-539-9177
Provider Business Practice Location Address
First Line : 401 11TH ST NE
Second Line :
City : SPRINGHILL
State : LA
Zip : 71075-4503
Country : US
Telephone Number : 318-539-1701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 05/20/2021

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Directions to “ VINCENT BRYAN LOCOCO MD” Practice Location

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