Individual
SAM C BRIAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 S JONES ST, WINNFIELD, LA 71483-3251
(318) 628-3303
Mailing address
104 S JONES ST, WINNFIELD, LA 71483-3251
(318) 628-3303
(318) 628-7122
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9491
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1211001
—
LA
Enumeration date
09/15/2008
Last updated
03/02/2009
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