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Individual

BRANDON LANE PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 PAVILION RD, WEST MONROE, LA 71292-9470
(318) 323-1100
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
303412
LA
2080P0202X
Pediatric Cardiology Physician
N5944
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09731876
MS
05
2430718
LA
Enumeration date
07/11/2007
Last updated
11/01/2022
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