Individual
MR. BRETT BANKSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8888 SUMMA AVE FL 3, BATON ROUGE, LA 70809-3772
(225) 763-4000
Mailing address
18023 OLD TRAIL DR, PRAIRIEVILLE, LA 70769-5586
(225) 276-3618
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1197616
LA
Other
Enumeration date
06/13/2024
Last updated
06/14/2024
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