Provider Demographics
NPI:1689739559
Name:J. DARVIN HALES, DO, FCCP, APMC
Entity Type:Organization
Organization Name:J. DARVIN HALES, DO, FCCP, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DARVIN
Authorized Official - Last Name:HALES
Authorized Official - Suffix:
Authorized Official - Credentials:DO, FCCP, DABSM
Authorized Official - Phone:337-364-8500
Mailing Address - Street 1:2309 EAST MAIN STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-0000
Mailing Address - Country:US
Mailing Address - Phone:337-364-8500
Mailing Address - Fax:337-364-8582
Practice Address - Street 1:2309 EAST MAIN STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-0000
Practice Address - Country:US
Practice Address - Phone:337-364-8500
Practice Address - Fax:337-364-8582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013979207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1650986Medicaid
LA1650986Medicaid
LA5CC62Medicare PIN