Provider Demographics
NPI:1659462398
Name:LAROCQUE, JAMES C (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:LAROCQUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 CHURCHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5205
Mailing Address - Country:US
Mailing Address - Phone:757-484-7822
Mailing Address - Fax:757-484-7362
Practice Address - Street 1:3205 CHURCHLAND BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5205
Practice Address - Country:US
Practice Address - Phone:757-484-7822
Practice Address - Fax:757-484-7362
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034393207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA466194OtherANTHEM BC/BS
VA006007406Medicaid
VA4037922OtherAETNA
VA466194OtherANTHEM BC/BS
VAC47725Medicare UPIN