Individual
JACQUES A DE LA BRETONNE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5422 DIJON DR, BATON ROUGE, LA 70808-4315
(225) 769-9337
Mailing address
PO BOX 14530, BATON ROUGE, LA 70898-4530
(225) 769-6700
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
013215
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1197963
—
LA
Enumeration date
06/14/2006
Last updated
07/08/2007
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