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General NPI Number Information
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NPI Number | 1659535847
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Entity Type | Organization
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Legal Business Name | BRADLEY M BLAPPERT MD
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 04/20/2009
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Provider Practice Location Address
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Address Line | 5000 AMBASSADOR CAFFERY PKWY BUILDING 6B
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City | LAFAYETTE
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State | LA
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Zip | 70508-6984
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Country | US
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Telephone | 337-984-1124
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Fax | 337-984-1436
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Provider Business Mailing Address
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Address Line | 5000 AMBASSADOR CAFFERY PKWY BUILDING 6B
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City | LAFAYETTE
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State | LA
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Zip | 70508-6984
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Country | US
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Telephone | 337-984-1124
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Fax | 337-984-1436
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Authorized Official
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Title or Position | OWNER / OPERATOR
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Name | BRADLEY M BLAPPERT
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Credential | MD
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Telephone | 337-984-1124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2022254
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License Number State | LA
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