Individual
MR. CHRISTOPHER TROY BAMBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1635 MARVEL ST, COUSHATTA, LA 71019-9022
(318) 932-2000
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
303579
LA
363AM0700X
Medical Physician Assistant
Primary
303579
LA
Other
Enumeration date
09/23/2016
Last updated
07/03/2019
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