Provider Demographics
NPI:1437537495
Name:J DAUZART ANESTHESIA LLC
Entity Type:Organization
Organization Name:J DAUZART ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:DAUZART
Authorized Official - Suffix:JR
Authorized Official - Credentials:CRNA
Authorized Official - Phone:225-229-3407
Mailing Address - Street 1:101 TORTOLA LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5760
Mailing Address - Country:US
Mailing Address - Phone:225-229-3407
Mailing Address - Fax:
Practice Address - Street 1:101 TORTOLA LN
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5760
Practice Address - Country:US
Practice Address - Phone:225-229-3407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP02556367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty