Provider Demographics
NPI:1174969133
Name:PICOU, BRYAN ANTHONY JR (MD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:ANTHONY
Last Name:PICOU
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1029 KEYSER AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-6239
Mailing Address - Country:US
Mailing Address - Phone:318-352-2971
Mailing Address - Fax:318-356-0850
Practice Address - Street 1:1029 KEYSER AVE
Practice Address - Street 2:SUITE G
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6239
Practice Address - Country:US
Practice Address - Phone:318-352-2971
Practice Address - Fax:318-356-0850
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2016-10-10
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Provider Licenses
StateLicense IDTaxonomies
LAMD.208184207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine