| Mr Christopher Troy Bamburg, PA-C | |
|
1635 Marvel St, Coushatta, LA 71019-9022 | |
| (318) 932-2000 | |
| Not Available |
| Full Name | Mr Christopher Troy Bamburg |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 1635 Marvel St, Coushatta, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003365636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 303579 (Louisiana) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 303579 (Louisiana) | Primary |
| Entity Name | Christus Health Central Louisiana |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205824208 PECOS PAC ID: 4688570955 Enrollment ID: O20050427001022 |
| Entity Name | Sound Physicians Emergency Medicine of Louisiana Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396253407 PECOS PAC ID: 1759642739 Enrollment ID: O20180308001149 |
| Entity Name | Cross Lake Emergency Group, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013497114 PECOS PAC ID: 5395096440 Enrollment ID: O20180928000987 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Christopher Troy Bamburg, PA-C 200 Corporate Blvd, Lafayette, LA 70508-3870 Ph: (800) 893-9698 | Mr Christopher Troy Bamburg, PA-C 1635 Marvel St, Coushatta, LA 71019-9022 Ph: (318) 932-2000 |
Melanie Paul Francis, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1635 Marvel St, Coushatta, LA 71019 Phone: 318-294-4498 |
Mr. Thomas William Coleman, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1635 Marvel St, Coushatta, LA 71019 Phone: 318-932-2085 Fax: 318-932-2215 |