Healthcare Provider Details

I. General information

NPI: 1053308791
Provider Name (Legal Business Name): JAMES R HANLEY III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HIGHWAY
NEW ORLEANS LA
70121
US

IV. Provider business mailing address

1514 JEFFERSON HIGHWAY
NEW ORLEANS LA
70121
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-4000
  • Fax:
Mailing address:
  • Phone: 504-842-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberMD203408
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD28126
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number27393
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME 0056444
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101053281
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: