Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 206094 | LA |
NPI | 1467655456 |
---|---|
Provider Name | Brad Anthony Culotta |
First Address | Baton Rouge, LA 70810-7827 |
Second Address | Baton Rouge, LA 70810-7827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 29/05/2013 |