Healthcare Provider Details

I. General information

NPI: 1275526196
Provider Name (Legal Business Name): JAMES S GARCELON M.D.,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date: 03/27/2006
Reactivation Date: 04/12/2006

III. Provider practice location address

1211 COOLIDGE BLVD SUITE 304
LAFAYETTE LA
70503-2636
US

IV. Provider business mailing address

1211 COOLIDGE BLVD SUITE 304
LAFAYETTE LA
70503-2636
US

V. Phone/Fax

Practice location:
  • Phone: 337-236-3030
  • Fax: 337-235-0094
Mailing address:
  • Phone: 337-236-3030
  • Fax: 337-235-0094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number10007R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: