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1770581811

NPI Code Detail

MEDICARE: DR. BRADLEY J CHASTANT MD

MEDICARE: DR. BRADLEY J CHASTANT MD

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	207YS0123X	Facial Plastic Surgery Physician	L017239	LA
2	207Y00000X	Otolaryngology Physician	L017239	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	070007863	OTHER	LA	RR MED
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770581811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY J CHASTANT MD

Provider Business Mailing Address
First Line	:	1000 W PINHOOK RD STE 201
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2464
Country	:	US
Telephone Number	:	337-237-0650
Fax Number	:	888-990-2781

Provider Business Practice Location Address
First Line	:	1000 W PINHOOK RD STE 201
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2464
Country	:	US
Telephone Number	:	337-237-0650
Fax Number	:	888-990-2781

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/07/2021

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Directions to “ DR. BRADLEY J CHASTANT MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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