Provider Demographics
NPI:1003889163
Name:POLLARD, JAMES EUGENE (MD, DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EUGENE
Last Name:POLLARD
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-6302
Mailing Address - Country:US
Mailing Address - Phone:337-626-1444
Mailing Address - Fax:337-626-7446
Practice Address - Street 1:3704 MAPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-6302
Practice Address - Country:US
Practice Address - Phone:337-626-1444
Practice Address - Fax:337-626-7446
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3363174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1833631Medicaid
LA1833631Medicaid