Provider Demographics
NPI:1740691831
Name:RABALAIS, JAMES GRANT (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GRANT
Last Name:RABALAIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1103 KALISTE SALOOM RD STE 304
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5784
Mailing Address - Country:US
Mailing Address - Phone:337-988-5646
Mailing Address - Fax:337-988-4298
Practice Address - Street 1:1103 KALISTE SALOOM RD STE 304
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5784
Practice Address - Country:US
Practice Address - Phone:337-988-5646
Practice Address - Fax:337-988-4298
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
LA311429207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program