MEDICARE: JAMES DANTONI 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	207Q00000X	Family Medicine Physician	23058	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

General Provider Information

NPI Number	:	1922007491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES DANTONI M.D.

Provider Business Mailing Address
First Line	:	17609 OLD JEFFERSON HWY
Second Line	:
City	:	PRAIRIEVILLE
State	:	LA
Zip	:	70769-3979
Country	:	US
Telephone Number	:	225-677-9595
Fax Number	:	225-644-5213

Provider Business Practice Location Address
First Line	:	17609 OLD JEFFERSON HWY
Second Line	:
City	:	PRAIRIEVILLE
State	:	LA
Zip	:	70769-3979
Country	:	US
Telephone Number	:	225-677-9595
Fax Number	:	225-644-5213

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	03/25/2021

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Directions to “ JAMES DANTONI M.D.” Practice Location

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