Provider Demographics
NPI:1114997723
Name:JIHA, JIHAD G (MD)
Entity Type:Individual
Prefix:DR
First Name:JIHAD
Middle Name:G
Last Name:JIHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JIHAD
Other - Middle Name:G
Other - Last Name:JIHA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2220 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1303
Mailing Address - Country:US
Mailing Address - Phone:225-931-9935
Mailing Address - Fax:
Practice Address - Street 1:5408 FLANDERS DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9168
Practice Address - Country:US
Practice Address - Phone:225-769-5554
Practice Address - Fax:225-769-5502
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15356R208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4F880Medicare ID - Type Unspecified
LAG70643Medicare UPIN