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Individual

BRAD JOSEPH FANGUY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D

Contact information

Practice address
106 ABIGAYLE ROW, SCOTT, LA 70583-8909
(337) 268-4023
(337) 268-4043
Mailing address
106 ABIGAYLE ROW, SCOTT, LA 70583-8909
(337) 268-4023

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
45092
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1899453
LA
Enumeration date
05/13/2010
Last updated
12/23/2025
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