MEDICARE: ST TAMMANY EMERGENCY PHYSICIANS GROUP LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	363A00000X	Physician Assistant
3	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1972319358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST TAMMANY EMERGENCY PHYSICIANS GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 649308
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75264-9308
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 4TH ST
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-8421
Country	:	US
Telephone Number	:	318-769-3000
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	BRETT MCINTYRE
Credential	:
Telephone Number	:	850-602-0625

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	12/29/2025

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