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Individual

BRANDY D ROY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3460
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3460

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D0071882
MD
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
MD.207632
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07123361
MS
05
2382772
LA
Enumeration date
06/05/2007
Last updated
09/25/2015
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