MEDICARE: DR. JAMES EDWARD HINES III M. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	04639R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154463305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES EDWARD HINES III M. D.

Provider Business Mailing Address
First Line	:	2149 N FOSTER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-1012
Country	:	US
Telephone Number	:	225-356-9775
Fax Number	:	225-357-7768

Provider Business Practice Location Address
First Line	:	2149 N FOSTER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-1012
Country	:	US
Telephone Number	:	225-356-9775
Fax Number	:	225-357-7768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	04/08/2014

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