Provider Demographics
NPI:1740423169
Name:JAMES J. LANASA, JR. M.D., P.M.C.
Entity type:Organization
Organization Name:JAMES J. LANASA, JR. M.D., P.M.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANASA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:225-769-7560
Mailing Address - Street 1:2223 QUAIL RUN
Mailing Address - Street 2:SUITE E
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9063
Mailing Address - Country:US
Mailing Address - Phone:225-769-7560
Mailing Address - Fax:225-769-7562
Practice Address - Street 1:2223 QUAIL RUN
Practice Address - Street 2:SUITE E
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9063
Practice Address - Country:US
Practice Address - Phone:225-769-7560
Practice Address - Fax:225-769-7562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA010498207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA53432Medicare UPIN