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General NPI Number Information
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NPI Number | 1114486370
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Entity Type | Individual
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Provider Name | BRADLEY LANDWEHR MD
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Gender | Male
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 3705 COLISEUM ST
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City | NEW ORLEANS
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State | LA
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Zip | 70115-3708
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Country | US
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Telephone | 504-605-1100
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Fax | 504-891-5859
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Provider Business Mailing Address
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Address Line | 3705 COLISEUM ST
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City | NEW ORLEANS
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State | LA
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Zip | 70115-3708
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Country | US
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Telephone | 504-605-1100
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Fax | 504-891-5859
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 313131
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 333660
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License Number State | LA
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