Provider Demographics
NPI:1912008723
Name:JAMES C. LAROCQUE
Entity Type:Organization
Organization Name:JAMES C. LAROCQUE
Other - Org Name:ENDOCRINOLOGY & DIABETES CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAROCQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-484-7822
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA233809OtherSENTARA / OPTIMA
VA466182OtherANTHEM GROUP ID