MEDICARE: SUSAN J BRYANT 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
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	021783	LA
2	208VP0000X	Pain Medicine Physician	021783	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1609842947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN J BRYANT MD

Provider Business Mailing Address
First Line	:	29301 N DIXIE RANCH RD
Second Line	:
City	:	LACOMBE
State	:	LA
Zip	:	70445
Country	:	US
Telephone Number	:	985-871-4114
Fax Number	:	985-871-4130

Provider Business Practice Location Address
First Line	:	3434 HOUMA BLVD STE 301
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70006-4201
Country	:	US
Telephone Number	:	504-635-2601
Fax Number	:	504-324-2078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	12/30/2021

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Directions to “ SUSAN J BRYANT MD” Practice Location

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