Individual ProviderBrent Oliver CampanellaFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address5131 Essen Ln, Baton Rouge, LA 70809-3541(225) 769-0043PECOS EnrollmentBased on the most recent information from CMS, provider Brent Oliver Campanella does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1003847369Provider TypeIndividualFull NameCampanella, Brent OliverTitleDr.CredentialM.D.GenderMaleSole ProprietorYesEnumeration Date7/5/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address5131 Essen Ln, Baton Rouge, LA 70809-3541Phone(225) 769-0043Fax(225) 769-0133Mailing LocationMailing Address5131 Essen Ln, Baton Rouge, LA 70809-3541Phone(225) 769-0043Fax(225) 769-0133Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense017472LouisianaProvider IdentifiersIDDescriptionIssuerID1393053DescriptionMedicaidIssuerUnlistedLouisiana