MEDICARE: DR. WILLIAM A. BRENNAN M.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
1	207T00000X	Neurological Surgery Physician	MD.202641	LA

General Provider Information

NPI Number	:	1578784468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM A. BRENNAN M.D.

Provider Business Mailing Address
First Line	:	4212 W. CONGESS ST.
Second Line	:	SUITE 3500
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-6765
Country	:	US
Telephone Number	:	337-981-2125
Fax Number	:	337-981-2174

Provider Business Practice Location Address
First Line	:	4212 W CONGRESS STREET
Second Line	:	SUITE 3500
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-6765
Country	:	US
Telephone Number	:	337-981-2125
Fax Number	:	337-981-2174

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	02/17/2012

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