Provider Demographics
NPI:1336336668
Name:HALPHEN, JOSEPH L (PAC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:L
Last Name:HALPHEN
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 98035
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70898-9035
Mailing Address - Country:US
Mailing Address - Phone:225-766-0050
Mailing Address - Fax:225-766-1499
Practice Address - Street 1:7301 HENNESSY BLVD
Practice Address - Street 2:#200
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-766-0050
Practice Address - Fax:225-766-1499
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA200130363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1329959Medicaid
LA5C822PA80Medicare PIN