Individual
MR. THOMAS L BRISCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1245 S COLLEGE RD BLDG 5, LAFAYETTE, LA 70503-2917
(337) 235-6886
(337) 235-6892
Mailing address
400 MILL POND DR, YOUNGSVILLE, LA 70592-5668
(337) 241-9269
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PST.015227
LA
363A00000X
Physician Assistant
A10327
LA
363AM0700X
Medical Physician Assistant
Primary
A10327
LA
363AM0700X
Medical Physician Assistant
A10327.RX
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1351016
—
LA
Enumeration date
11/04/2005
Last updated
07/10/2019
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