Healthcare Provider Details

I. General information

NPI: 1821019282
Provider Name (Legal Business Name): MARK L. JAMES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82525 HIGHWAY 25
FOLSOM LA
70437-6111
US

IV. Provider business mailing address

PO BOX 54482
NEW ORLEANS LA
70154-4482
US

V. Phone/Fax

Practice location:
  • Phone: 985-839-9895
  • Fax: 985-839-9884
Mailing address:
  • Phone: 985-839-9895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number016216
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16216
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: