Bruce Lamar Addison Jr.

Individual provider Active NPI Case Manager/Care Coordinator · Monroe, LA

NPI 1720793003 · NPPES record last updated Jan 20, 2023

Key facts

NPI
1720793003
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
2101 Tower Dr Ste B
Monroe, LA 71201-5045
Phone
(318) 570-5400
Fax
(318) 323-1400
NPI assigned
Jan 20, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

2101 Tower Dr Ste B
Monroe, LA 71201-5045

Mailing address

2101 Tower Dr Ste B
Monroe, LA 71201-5045
Phone (318) 570-5400

Other providers in Monroe, LA

All providers in Monroe, LA · Case Manager/Care Coordinator in Louisiana

Sources for this page

Verify at the official NPI Registry.