Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | MD203408 | LA |
N | 208000000X | Pediatrician | 0101053281 | VA |
N | 208000000X | Pediatrician | 27393 | AL |
N | 208000000X | Pediatrician | MD28126 | TN |
N | 208000000X | Pediatrician | ME 0056444 | FL |
NPI | 1053308791 |
---|---|
Provider Name | James R Hanley III |
First Address | New Orleans, LA 70121 |
Second Address | New Orleans, LA 70121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 13/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009910809 | (05) | AL |
04029336 | (05) | MS |
1807711 | (05) | LA |
3810235 | (05) | TN |
515541854 | BCBS - 1504 SPRINGHILL (01) | AL |
E94138 | (02) |