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General NPI Number Information
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NPI Number | 1770089617
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Entity Type | Individual
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Provider Name | JOHN COLIN BRIAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2018
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 104 N 3RD ST
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8581
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Country | US
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Telephone | 318-623-3534
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Fax |
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Provider Business Mailing Address
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Address Line | 220 SAINT ANDREWS DR
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City | ALEXANDRIA
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State | LA
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Zip | 71303-9721
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Country | US
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Telephone | 318-623-3534
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 327715
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License Number State | LA
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