Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M8654 | TX |
N | 111NI0900X | Internist | M8654 | TX |
Y | 207R00000X | Internist | MD.205149 | LA |
Y | 111NI0900X | Internist | MD.205149 | LA |
N | 208000000X | Pediatrician | MD205149 | LA |
NPI | 1003857236 |
---|---|
Provider Name | Dr. Janice L Ford |
First Address | West Monroe, LA 71291 |
Second Address | West Monroe, LA 71291-5503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 30/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
198386801 | (05) | TX |
8G9389 | BCBS (01) | TX |
I43185 | (02) |