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NPI Code Detail

MEDICARE: DR. BRENT K COMBS DO

MEDICARE: DR. BRENT K COMBS DO
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
1207PP0204XPediatric Emergency Medicine (Emergency Medicine) PhysicianDO.025843LA
2207PP0204XPediatric Emergency Medicine (Emergency Medicine) PhysicianMD.025843LA
3208000000XPediatrics PhysicianDO.025843LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235163627
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRENT K COMBS DO
Provider Business Mailing Address
First Line : 5959 S SHERWOOD FOREST BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-6038
Country : US
Telephone Number : 225-526-0006
Fax Number : 225-765-9291
Provider Business Practice Location Address
First Line : 8300 CONSTANTIN BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3489
Country : US
Telephone Number : 225-374-1410
Fax Number : 225-374-1616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 01/28/2022

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Directions to “ DR. BRENT K COMBS DO” Practice Location

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