Provider Demographics
NPI:1427332584
Name:BRANCH, RUFFIN CHASE (PA-C)
Entity type:Individual
Prefix:MR
First Name:RUFFIN
Middle Name:CHASE
Last Name:BRANCH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70438-3688
Mailing Address - Country:US
Mailing Address - Phone:985-848-9955
Mailing Address - Fax:985-848-9964
Practice Address - Street 1:51704 HIGHWAY 438
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-7488
Practice Address - Country:US
Practice Address - Phone:985-848-9955
Practice Address - Fax:985-848-9964
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200480363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2180886Medicaid
LA2180886Medicaid