Individual
GERALD KANE O'BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1990 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053
Mailing address
3650 LOYOLA DR APT 108, KENNER, LA 70065-5431
(504) 467-8771
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
201218
LA
207R00000X
Internal Medicine Physician
Primary
201218
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073806
—
LA
Enumeration date
11/21/2007
Last updated
10/10/2012
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