Individual
DR. BRIAN RICHARD HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1525 OAK PARK BLVD, LAKE CHARLES, LA 70601
(377) 494-6767
(337) 494-6750
Mailing address
PO BOX 123453 DEPT 3453, DALLAS, TX 75312-0001
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD.201393
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1501204
—
LA
01
—
MD.201393
STATE MEDICAL LICENSE
LA
Enumeration date
03/07/2007
Last updated
04/27/2022
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