Provider Demographics
NPI:1225377856
Name:JAMES J LANASA JR MD PMC
Entity Type:Organization
Organization Name:JAMES J LANASA JR MD PMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANASA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:225-769-7560
Mailing Address - Street 1:2223 QUAIL RUN DR.
Mailing Address - Street 2:STE E
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808
Mailing Address - Country:US
Mailing Address - Phone:225-769-7560
Mailing Address - Fax:225-769-7500
Practice Address - Street 1:2223 QUAIL RUN DR.
Practice Address - Street 2:STE E
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-769-7560
Practice Address - Fax:225-769-7500
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMES J LANASA JR MD PMC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA010498207Y00000X, 207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty