MEDICARE: BRYN-FINCHER PULMONARY & CRITICAL CARE

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	207RP1001X	Pulmonary Disease Physician

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
2	14433	OTHER	LA	BCBS LA

General Provider Information

NPI Number	:	1770683997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRYN-FINCHER PULMONARY & CRITICAL CARE

Provider Business Mailing Address
First Line	:	2551 GREENWOOD ROAD
Second Line	:	STE 210
City	:	SHREVEPORT
State	:	LA
Zip	:	71103-3905
Country	:	US
Telephone Number	:	318-635-0834
Fax Number	:	318-636-2331

Provider Business Practice Location Address
First Line	:	2551 GREENWOOD ROAD
Second Line	:	STE 210
City	:	SHREVEPORT
State	:	LA
Zip	:	71103-3905
Country	:	US
Telephone Number	:	318-635-0834
Fax Number	:	318-636-2331

Authorized Official
Title or Position	:	ADMINISTRATOR OFFICE MANAGER
Name	:	MRS. BONNIE P BRYN
Credential	:	RN
Telephone Number	:	318-635-0834

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	08/22/2020

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Directions to “BRYN-FINCHER PULMONARY & CRITICAL CARE ” Practice Location

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