Individual ProviderChad BradenFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address9001 Summa Ave, Baton Rouge, LA 70809-3726(225) 761-5480(225) 761-5200PECOS EnrollmentBased on the most recent information from CMS, provider Chad Braden is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1447217336Provider TypeIndividualFull NameBraden, ChadTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date4/26/2006Last Updated12/6/2007Contact InformationPractice LocationPractice Address9001 Summa Ave, Baton Rouge, LA 70809-3726Phone(225) 761-5480Fax(225) 761-5487Mailing LocationMailing Address9001 Summa Ave, Baton Rouge, LA 70809-3726Phone(225) 761-5200FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseMD13519RLouisianaProvider IdentifiersIDDescriptionIssuerID1432822DescriptionMedicaidIssuerUnlistedLouisiana