Healthcare Provider Details

I. General information

NPI: 1689739559
Provider Name (Legal Business Name): J. DARVIN HALES, DO, FCCP, APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 09/23/2009
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

Practice location:
  • Phone: 337-364-8500
  • Fax: 337-364-8582
Mailing address:
  • Phone: 337-364-8500
  • Fax: 337-364-8582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number013979
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number013979
License Number StateLA

VIII. Authorized Official

Name: DR. JAMES DARVIN HALES
Title or Position: OWNER
Credential: DO, FCCP, DABSM
Phone: 337-364-8500