Provider Demographics
NPI:1144377128
Name:CHADHA, JAGJIT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAGJIT
Middle Name:
Last Name:CHADHA
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 1:140 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DEQUINCY
Mailing Address - State:LA
Mailing Address - Zip Code:70633-3508
Mailing Address - Country:US
Mailing Address - Phone:337-786-5007
Mailing Address - Fax:337-786-5009
Practice Address - Street 1:140 W 4TH ST
Practice Address - Street 2:
Practice Address - City:DEQUINCY
Practice Address - State:LA
Practice Address - Zip Code:70633-3508
Practice Address - Country:US
Practice Address - Phone:337-786-5007
Practice Address - Fax:337-786-5009
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13083R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1555070Medicaid
LAG78270Medicare UPIN
LA5E922Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER