MEDICARE: JAMES E. CRAVEN IV M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	23614	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	023614	OTHER	LA	STATE LICENSE
3	026493	OTHER	LA	CDS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518962653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES E. CRAVEN IV M.D.

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	225-215-2255
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	7777 HENNESSY BLVD STE 103
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4363
Country	:	US
Telephone Number	:	225-215-2255
Fax Number	:	225-215-2266

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	08/18/2023

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