Healthcare Provider Details

I. General information

NPI: 1982601258
Provider Name (Legal Business Name): JAMES E YEGGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5131 ODONOVAN DR STE 100
BATON ROUGE LA
70808-4791
US

IV. Provider business mailing address

5131 ODONOVAN DR STE 100
BATON ROUGE LA
70808-4791
US

V. Phone/Fax

Practice location:
  • Phone: 225-767-4893
  • Fax: 225-767-5494
Mailing address:
  • Phone: 225-767-4893
  • Fax: 225-767-5494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number14439R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: