Healthcare Provider Details

I. General information

NPI: 1982859211
Provider Name (Legal Business Name): JAMES HENRY DIAZ SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 POYDRAS ST SUITE 1400
NEW ORLEANS LA
70112-1254
US

IV. Provider business mailing address

313 FRIEDRICHS AVE
METAIRIE LA
70005-4518
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-6052
  • Fax: 504-568-5701
Mailing address:
  • Phone: 504-835-0920
  • Fax: 504-835-5645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number13125
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number13125
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number13125
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number13125
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License Number13125
License Number StateLA
# 6
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number13125
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: