Provider Demographics
NPI:1932789468
Name:JUDICE, RONALD JAMES JR
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JAMES
Last Name:JUDICE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 DICKENS ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2247
Mailing Address - Country:US
Mailing Address - Phone:337-281-6481
Mailing Address - Fax:
Practice Address - Street 1:106 HEYMANN BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2322
Practice Address - Country:US
Practice Address - Phone:337-504-4279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist