Christopher Troy Bamburg, PA-C
Physician Assistant, Medical in Coushatta, LA. Individual provider (NPI-1).
NPI number1003365636
StatusActive
Last updated in NPPESJul 3, 2019
Details
- NPI
- 1003365636
- Entity type
- Individual (NPI-1)
- Name
- Mr. Christopher Troy Bamburg
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 23, 2016
- Last updated
- Jul 3, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 303579 | LA | Yes |
| 363A00000X | Physician Assistant | 303579 | LA |
Practice location
1635 Marvel StCoushatta, LA 71019-9022
Phone 318-932-2000
Mailing address
200 Corporate BlvdLafayette, LA 70508-3870
Phone 800-893-9698
Other practice locations
2510 Bert Kouns Industrial Loop
Shreveport, LA 71118-3180
Shreveport, LA 71118-3180
Phone 318-212-5000 · Fax 318-632-5217
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