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Individual

DR. BRIAN A HEISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
330 LEE DR., SUITE B, BATON ROUGE, LA 70808-1601
(225) 926-4780
(225) 926-4783
Mailing address
330 LEE DR., SUITE B, BATON ROUGE, LA 70808-1601
(225) 926-4780
(225) 926-4783

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.12387R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-02804
UNITED HEALTH PLAN
LA
05
1429171
LA
01
5780698
AETNA HEALTH PLAN
LA
Enumeration date
02/14/2006
Last updated
07/08/2007
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