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General NPI Number Information
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NPI Number | 1003891433
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Entity Type | Individual
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Provider Name | JAMES G RALSTON MD
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Gender | Male
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 65 MEDICAL PARK BLVD STE 101
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City | PINEVILLE
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State | LA
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Zip | 71360-8428
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Country | US
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Telephone | 318-473-9958
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Fax | 318-443-6935
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Provider Business Mailing Address
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Address Line | 65 MEDICAL PARK BLVD STE 101
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City | PINEVILLE
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State | LA
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Zip | 71360-8428
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Country | US
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Telephone | 318-473-9958
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Fax | 318-443-6935
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 016869
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License Number State | LA
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