1346536190 NPI number — DR. ANTHONY JOSEPH BERCIER DDS

Table of content: DR. ANTHONY JOSEPH BERCIER DDS (NPI 1346536190)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346536190 NPI number — DR. ANTHONY JOSEPH BERCIER DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERCIER
Provider First Name:
ANTHONY
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346536190
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 23
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAYNE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70578-0023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-788-0160
Provider Business Mailing Address Fax Number:
337-334-2812

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 N POLK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAYNE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70578-6551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-334-3581
Provider Business Practice Location Address Fax Number:
337-334-2812
Provider Enumeration Date:
06/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  6196 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com