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General NPI Number Information
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NPI Number | 1861648800
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Entity Type | Individual
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Provider Name | LOUIE ANTHONY GARCIA JAIN MD
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Gender | Male
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 1575 BEAM AVE
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City | MAPLEWOOD
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State | MN
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Zip | 55109-1126
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Country | US
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Telephone | 651-232-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 UNIVERSITY AVE W FL 6
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City | SAINT PAUL
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State | MN
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Zip | 55104-3727
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Country | US
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Telephone |
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2011-00740
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | Q3019
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 61085
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License Number State | MN
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