Organization
CALAIS DERMATOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BRETTON BRANTLEY MD (OWNER PHYSICIAN)
(225) 766-5151
Entity
Organization
Contact information
Practice address
5220 FLANDERS DRIVE, BATON ROUGE, LA 70808
(225) 766-5151
(225) 766-8216
Mailing address
5220 FLANDERS DRIVE, BATON ROUGE, LA 70808
(225) 766-5151
(225) 766-8216
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1943487
—
LA
Enumeration date
06/27/2006
Last updated
11/01/2013
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