Individual
TAYLOR BRYAN THEUNISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5233 DIJON DR, BATON ROUGE, LA 70808-4692
(225) 218-6108
(225) 223-6010
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0006
(225) 765-9291
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
026454
LA
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
026454
LA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
026454
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05285897
—
MS
05
—
1063444
—
LA
Enumeration date
07/30/2007
Last updated
04/28/2016
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