Provider Demographics
NPI:1811326606
Name:BARTLETT, DANIEL SCOTT (PA-C)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:SCOTT
Last Name:BARTLETT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:DANNY
Other - Middle Name:S
Other - Last Name:BARTLETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 848565
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-8565
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-2609
Practice Address - Street 1:3330 MASONIC DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3841
Practice Address - Country:US
Practice Address - Phone:318-483-4090
Practice Address - Fax:318-483-4066
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200681363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant