Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | H9497 | TX |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 205889 | LA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | H9497 | TX |
NPI | 1356353544 |
---|---|
Provider Name | Dr. Michael Wayne Britt |
First Address | Shreveport, LA 71103-3822 |
Second Address | Shreveport, LA 71103-4228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 22/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003709-02 | (05) | TX |
268560YH54 | MEDICARE - PTAN (01) | LA |
G26754 | (02) |