Healthcare Provider Details

I. General information

NPI: 1619933181
Provider Name (Legal Business Name): JAMES GEORGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 HIGHWAY 190
EUNICE LA
70535-5129
US

IV. Provider business mailing address

224 ORANGEWOOD DR
LAFAYETTE LA
70503-5127
US

V. Phone/Fax

Practice location:
  • Phone: 337-580-7900
  • Fax: 337-580-7902
Mailing address:
  • Phone: 337-948-2188
  • Fax: 337-981-1308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number024923
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number024923
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: