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General NPI Number Information
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NPI Number | 1902258486
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Entity Type | Organization
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Legal Business Name | JPHIR LLC
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Dates
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Enumeration Date | 07/07/2016
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Last Update Date | 07/07/2016
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Provider Practice Location Address
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Address Line | 10440 HOOPER RD
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City | BATON ROUGE
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State | LA
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Zip | 70818-3203
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Country | US
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Telephone | 225-930-0060
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Fax | 225-952-9075
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Provider Business Mailing Address
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Address Line | PO BOX 14149
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City | BATON ROUGE
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State | LA
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Zip | 70898-4149
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Country | US
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Telephone | 225-930-0060
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Fax | 225-952-9075
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN P HAMIDE
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Credential | M.D.
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Telephone | 225-930-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 024935
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License Number State | LA
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