Provider Demographics
NPI:1679393862
Name:BRIGHT FUTURES PEDIATRICS, LLC
Entity type:Organization
Organization Name:BRIGHT FUTURES PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:CPNP
Authorized Official - Phone:318-443-9634
Mailing Address - Street 1:41 CALVERT DR STE D
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3520
Mailing Address - Country:US
Mailing Address - Phone:318-443-9634
Mailing Address - Fax:318-443-9809
Practice Address - Street 1:41 CALVERT DR STE D
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3520
Practice Address - Country:US
Practice Address - Phone:318-443-9634
Practice Address - Fax:318-443-9809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty