Provider Demographics
NPI:1255361879
Name:MAY, JAMES STAFFORD (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:STAFFORD
Last Name:MAY
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 1:6821 PINES RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2547
Mailing Address - Country:US
Mailing Address - Phone:318-687-5500
Mailing Address - Fax:318-687-5503
Practice Address - Street 1:6821 PINES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-2547
Practice Address - Country:US
Practice Address - Phone:318-687-5500
Practice Address - Fax:318-687-5503
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA012935207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1185809Medicaid
LA5H115CK54Medicare PIN
LA5H115Medicare PIN
B89057Medicare UPIN