Roy Braswell, M.D.
Individual provider Active NPI Emergency Medicine Physician · Monroe, LA
NPI 1619987690 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1619987690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 06140R (LA)
- Practice address
- 4864 Jackson St
Department of Emergency Medical Services
Monroe, LA 71202-6400 - Phone
- (318) 675-7737
- Fax
- (318) 675-5666
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06140R | LA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Castor Creek Emergency Physicians LLC | Emergency Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 06140R | LA | Yes |
Addresses
Primary practice location
4864 Jackson St
Department of Emergency Medical Services
Monroe, LA 71202-6400
Mailing address
1501 Kings Hwy
Managed Care
Shreveport, LA 71103-4228
Phone (318) 675-7737
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346667 | Medicaid | LA |
Other providers in Monroe, LA
- Cynthia Brantly
- Hanna Elise Brashier
- Ortadius Brass
- Robin Brass
- James Peyton Braswell
- Trenton D Bratton
- Danna Frances Braud
- Deontae Brazil
- Erin Robinson Breard
- Brentwood Acquisition Shreveport, Inc
All providers in Monroe, LA · Emergency Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.