Provider Demographics
NPI:1275526196
Name:GARCELON, JAMES S (MD,)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:GARCELON
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 1:1211 COOLIDGE BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2636
Mailing Address - Country:US
Mailing Address - Phone:337-236-3030
Mailing Address - Fax:337-235-0094
Practice Address - Street 1:1211 COOLIDGE BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2636
Practice Address - Country:US
Practice Address - Phone:337-236-3030
Practice Address - Fax:337-235-0094
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2011-01-27
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-04-12
Provider Licenses
StateLicense IDTaxonomies
LA10007R208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery