Provider Demographics
NPI:1932161064
Name:NELSON, JAMES LOUIS (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LOUIS
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 SANDERS AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403
Mailing Address - Country:US
Mailing Address - Phone:985-345-5604
Mailing Address - Fax:985-345-9111
Practice Address - Street 1:15790 PAUL VEGA MD DR
Practice Address - Street 2:NORTH OAKS HEALTH SYSTEM
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-230-7755
Practice Address - Fax:985-230-6482
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD02577R208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1137944Medicaid
C67623Medicare UPIN
LA54298Medicare ID - Type Unspecified