Individual
DR. BRANDON SCOTT AMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 CHAMPAGNE BLVD, BREAUX BRIDGE, LA 70517-3700
(337) 332-2178
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
307933
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2414062
—
LA
Enumeration date
04/15/2016
Last updated
06/04/2021
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