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Individual

MR. BRYANT ANTHONY ACOSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
609 W COURT ST STE B, WINNFIELD, LA 71483-2686
(318) 209-4646
(318) 209-4649
Mailing address
431 W LAFAYETTE ST, WINNFIELD, LA 71483-3463
(318) 648-0375
(318) 648-0378

Taxonomy

Speciality
Code
Description
License number
State
146L00000X
Paramedic
PO835285
LA
363AM0700X
Medical Physician Assistant
Primary
PA.A10303.RX
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1452602
LA
Enumeration date
02/19/2007
Last updated
07/21/2022
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