Healthcare Provider Details

I. General information

NPI: 1073784955
Provider Name (Legal Business Name): JAMES ANDREW MOROCK SR. M.D., FACP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 MAYWOOD ST
ALEXANDRIA LA
71302-2526
US

IV. Provider business mailing address

3915 MAYWOOD ST
ALEXANDRIA LA
71302-2526
US

V. Phone/Fax

Practice location:
  • Phone: 318-442-5776
  • Fax: 318-442-5796
Mailing address:
  • Phone: 318-442-5776
  • Fax: 318-442-5796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD.011583
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: