Provider Demographics
NPI:1386859106
Name:GROVES, JAMES WILLIAM JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:GROVES
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1890 W GAUTHIER RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-7179
Mailing Address - Country:US
Mailing Address - Phone:337-480-5530
Mailing Address - Fax:337-480-5531
Practice Address - Street 1:1890 W GAUTHIER RD
Practice Address - Street 2:SUITE 130
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-7179
Practice Address - Country:US
Practice Address - Phone:337-480-5530
Practice Address - Fax:337-480-5531
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
LA201254207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP00601494OtherRAILROAD MEDICARE
LA1014826Medicaid
LA201254OtherMEDICAL LICENSE
LA201254OtherMEDICAL LICENSE
FG0119962OtherDEA NUMBER
LA$$$$$$$$$0OtherBCBS