Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 00125994 | MS |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 014612 | LA |
NPI | 1538259478 |
---|---|
Provider Name | Dr. James Bennett |
First Address | New Orleans, LA 70112-2632 |
Second Address | New Orleans, LA 70112-2632 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 30/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1353361 | (05) | LA |
B62441 | (02) | LA |