Provider Demographics
NPI:1174589824
Name:BAGERT, BRIDGET A (MD)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:A
Last Name:BAGERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:4429 CLARA STREET
Practice Address - Street 2:# 440
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6973
Practice Address - Country:US
Practice Address - Phone:504-842-3980
Practice Address - Fax:504-412-1518
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.2020012084N0400X
MA2224492084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1141631Medicaid
MA2110407Medicaid
MAAA44629OtherHPHC
MS01605813Medicaid
MAJ29395OtherBCBSMA
LA4N127F669Medicare PIN
MA2110407Medicaid
MS01605813Medicaid
A39029Medicare ID - Type Unspecified
LA4N127Medicare PIN