Provider Demographics
NPI:1043208366
Name:JAFFRANI, NASEEM A (MD)
Entity Type:Individual
Prefix:DR
First Name:NASEEM
Middle Name:A
Last Name:JAFFRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 4TH ST
Mailing Address - Street 2:BOX 30115
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8421
Mailing Address - Country:US
Mailing Address - Phone:318-473-4613
Mailing Address - Fax:318-445-7129
Practice Address - Street 1:501 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 250
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8124
Practice Address - Country:US
Practice Address - Phone:318-473-4613
Practice Address - Fax:318-445-7129
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12156R207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA71301A007OtherTRICARE
LA1534021Medicaid
LA060049683OtherRAILROAD MEDICARE
MS00125835Medicaid
LA5Y959Medicare PIN
LA71301A007OtherTRICARE