MEDICARE: DR. JAMES T PATE 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	174400000X	Specialist	008637	LA
2	207Y00000X	Otolaryngology Physician	MD.008637	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	040016077	OTHER	LA	RAILROAD MEDICARE

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	:	1972506772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES T PATE M.D.

Provider Business Mailing Address
First Line	:	4124 JACKSON STREET EXT
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-2752
Country	:	US
Telephone Number	:	318-445-3653
Fax Number	:	318-445-3678

Provider Business Practice Location Address
First Line	:	4124 JACKSON STREET EXT
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-2752
Country	:	US
Telephone Number	:	318-445-3653
Fax Number	:	318-445-3678

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	11/16/2011

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Directions to “ DR. JAMES T PATE M.D.” Practice Location

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