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NPI Code Detail

MEDICARE: MR. JAMES R HERRIN PAC

MEDICARE:  MR. JAMES R HERRIN  PAC
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
1363A00000XPhysician AssistantA10505LA

Other Identifiers

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

General Provider Information

NPI Number : 1720079593
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES R HERRIN PAC
Provider Business Mailing Address
First Line : PO BOX 98035
Second Line :
City : BATON ROUGE
State : LA
Zip : 70898-9035
Country : US
Telephone Number : 225-766-0050
Fax Number : 225-766-1499
Provider Business Practice Location Address
First Line : 17199 SPRING RANCH RD STE 100
Second Line :
City : LIVINGSTON
State : LA
Zip : 70754-2900
Country : US
Telephone Number : 225-686-4900
Fax Number : 225-686-4901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 12/09/2022

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Directions to “ MR. JAMES R HERRIN PAC” Practice Location

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