Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 203757 | LA |
NPI | 1083881247 |
---|---|
Provider Name | Dr. Jeremy R James |
First Address | Covington, LA 70433-7208 |
Second Address | Covington, LA 70433-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 19/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05868 | (05) | LA |