Provider Demographics
NPI:1457639700
Name:JAMES S FINLEY MD A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JAMES S FINLEY MD A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SIDNEY
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:318-251-8001
Mailing Address - Street 1:1809 NORTHPOINTE LN STE 203
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-3852
Mailing Address - Country:US
Mailing Address - Phone:318-255-7591
Mailing Address - Fax:318-255-7584
Practice Address - Street 1:707 S VIENNA ST
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-5845
Practice Address - Country:US
Practice Address - Phone:318-251-8001
Practice Address - Fax:318-669-8843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.015037174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1351076Medicaid
LA5M7677837Medicare PIN