Healthcare Provider Details

I. General information

NPI: 1962493999
Provider Name (Legal Business Name): JAMES P. DAVID, M.D., A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 11/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 YORKTOWN DR
ALEXANDRIA LA
71303-3621
US

IV. Provider business mailing address

105 YORKTOWN DR
ALEXANDRIA LA
71303-3621
US

V. Phone/Fax

Practice location:
  • Phone: 318-445-0058
  • Fax: 318-484-9475
Mailing address:
  • Phone: 318-445-0058
  • Fax: 318-484-9475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES P. DAVID
Title or Position: VASCULAR SURGEON
Credential: MD
Phone: 318-445-0058