Healthcare Provider Details
I. General information
NPI: 1144289810
Provider Name (Legal Business Name): JAMES DARVIN HALES DO, FCCP, DABSM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/21/2006
Last Update Date: 11/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2309 EAST MAIN STREET SUITE 202
NEW IBERIA LA
70560-0000
US
IV. Provider business mailing address
2309 EAST MAIN STREET SUITE 202
NEW IBERIA LA
70560-0000
US
V. Phone/Fax
- Phone: 337-364-8500
- Fax: 337-364-8582
- Phone: 337-364-8500
- Fax: 337-364-8582
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 013979 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 013979 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: