DR. JERALD W BAMBURG PH.D. NPI 1598926644

NPI Information

NPI: 1598926644
Provider Name: DR. JERALD W BAMBURG, PH.D.
Classification: Psychologist - 103TM1800X
Entity Type: Individual

Specialization: Intellectual and Developmental Disabilities

PECOS Registration: Yes

Address:
106 N BEND DR
PINEVILLE, LA
ZIP 71360
Phone: (318) 442-4498
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DR. Jerald W Bamburg, PH.D. is an intellectual and developmental disabilities in Pineville, LA. DR. Jerald W Bamburg, PH.D. NPI is 1598926644. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

106 N BEND DR
PINEVILLE, LA
ZIP 71360-677
Phone: (318) 442-4498

The NPI 1598926644 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 6/20/2008 and was last updated on 1/11/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TC2200X	Psychologist	Clinical Child & Adolescent	951	LOUISIANA	No
2	103TM1800X	Psychologist	Intellectual and Developmental Disabilities	951	LOUISIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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