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NPI Code Detail

MEDICARE: SCOTT JOHN BROTHERS PH.D.

MEDICARE: SCOTT JOHN BROTHERS PH.D.
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
1103TC0700XClinical Psychologist688LA

General Provider Information

NPI Number : 1396868246
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT JOHN BROTHERS PH.D.
Provider Business Mailing Address
First Line : 1529 RIVER OAKS RD W
Second Line : SUITE 110
City : NEW ORLEANS
State : LA
Zip : 70123-2162
Country : US
Telephone Number : 504-734-1777
Fax Number : 504-736-0125
Provider Business Practice Location Address
First Line : 1529 RIVER OAKS RD W
Second Line : SUITE 110
City : NEW ORLEANS
State : LA
Zip : 70123-2162
Country : US
Telephone Number : 504-734-1777
Fax Number : 504-736-0125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2007
Last Update Date : 07/08/2007

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