Individual
DR. RANDALL P. BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8731 PARK PLAZA DR, SHREVEPORT, LA 71105
(318) 797-5848
(318) 797-5844
Mailing address
8731 PARK PLAZA DR, SHREVEPORT, LA 71105-5682
(318) 797-5848
(318) 797-5844
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD.021953
LA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD.021953
LA
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
MD.021953
LA
208VP0000X
Pain Medicine Physician
MD.021953
LA
208VP0014X
Interventional Pain Medicine Physician
Primary
MD.021953
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10915651
CAQH
—
05
—
1177458
—
LA
Enumeration date
01/31/2006
Last updated
10/04/2024
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