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NPI Code Detail

MEDICARE: KAY FRAZIER BUSH L.P.C.

MEDICARE: KAY FRAZIER BUSH L.P.C.
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
1101YP2500XProfessional Counselor2939LA

General Provider Information

NPI Number : 1073794004
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAY FRAZIER BUSH L.P.C.
Provider Business Mailing Address
First Line : 415 N CUTTING AVE
Second Line :
City : JENNINGS
State : LA
Zip : 70546-5963
Country : US
Telephone Number : 337-824-4200
Fax Number :
Provider Business Practice Location Address
First Line : 415 N CUTTING AVE
Second Line :
City : JENNINGS
State : LA
Zip : 70546-5963
Country : US
Telephone Number : 337-824-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2007
Last Update Date : 01/02/2008

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