MEDICARE: ERNEST JAMES MENCER 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	208600000X	Surgery Physician	04216R	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	312433YUB6	OTHER	LA	MEDICARE PTAN

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

General Provider Information

NPI Number	:	1639154412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERNEST JAMES MENCER M.D.

Provider Business Mailing Address
First Line	:	8490 PICARDY AVE
Second Line	:	BLDG 200
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3731
Country	:	US
Telephone Number	:	225-237-1754
Fax Number	:	225-237-1722

Provider Business Practice Location Address
First Line	:	3401 NORTH BLVD
Second Line	:	SUITE 200-B
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-3743
Country	:	US
Telephone Number	:	225-381-2615
Fax Number	:	225-381-2638

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	04/30/2014

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Directions to “ ERNEST JAMES MENCER M.D.” Practice Location

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