Provider Demographics
NPI:1972506772
Name:PATE, JAMES T (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:PATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4124 JACKSON STREET EXT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2752
Mailing Address - Country:US
Mailing Address - Phone:318-445-3653
Mailing Address - Fax:318-445-3678
Practice Address - Street 1:4124 JACKSON STREET EXT
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2752
Practice Address - Country:US
Practice Address - Phone:318-445-3653
Practice Address - Fax:318-445-3678
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008637174400000X
LAMD.008637207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1372358Medicaid
LA040016077OtherRAILROAD MEDICARE
LA1372358Medicaid
LA040016077OtherRAILROAD MEDICARE