Provider Demographics
NPI:1639512601
Name:JAMES, COURTNEY MICHELE (MD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MICHELE
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368 OAK BUILDING
Mailing Address - Street 2:
Mailing Address - City:ST. FRANCISVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70775
Mailing Address - Country:US
Mailing Address - Phone:225-635-9065
Mailing Address - Fax:225-635-9069
Practice Address - Street 1:10273 GOULD DRIVE
Practice Address - Street 2:
Practice Address - City:ST. FRANCISVILLE
Practice Address - State:LA
Practice Address - Zip Code:70775
Practice Address - Country:US
Practice Address - Phone:225-635-9065
Practice Address - Fax:225-635-9069
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA302489208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2305042Medicaid