=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871532408
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES M WEST MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2006
-----------------------------------------------------
Last Update Date | 07/31/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4701 MONTGOMERY BLVD NE
-----------------------------------------------------
City | ALBUQUERQUE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87109-1219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-893-9698
-----------------------------------------------------
Fax | 337-371-4656
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 CORPORATE BLVD SUITE 201
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70508-3870
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-805-1300
-----------------------------------------------------
Fax | 904-805-1302
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | 91-366
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------