Provider Demographics
NPI:1508862210
Name:JAMES, TRENTON L (MD)
Entity Type:Individual
Prefix:
First Name:TRENTON
Middle Name:L
Last Name:JAMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 261166
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70826-1166
Mailing Address - Country:US
Mailing Address - Phone:337-289-8971
Mailing Address - Fax:337-289-8970
Practice Address - Street 1:8595 PICARDY AVE
Practice Address - Street 2:STE 100
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3674
Practice Address - Country:US
Practice Address - Phone:225-763-4900
Practice Address - Fax:225-763-4938
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA010212207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1116041Medicaid
LA1116041Medicaid
B63752Medicare UPIN