Provider Demographics
NPI:1376602888
Name:BIRKE, JAMES A (PT PHD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:BIRKE
Suffix:
Gender:M
Credentials:PT PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15643 HOGENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-2436
Mailing Address - Country:US
Mailing Address - Phone:225-987-9013
Mailing Address - Fax:
Practice Address - Street 1:1401 N FOSTER DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1818
Practice Address - Country:US
Practice Address - Phone:225-987-9013
Practice Address - Fax:225-987-9022
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA03776R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist