Basic Information
| Provider Information | |||||||||
| NPI: | 1053308791 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANLEY | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1514 JEFFERSON HIGHWAY | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048424000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1514 JEFFERSON HIGHWAY | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048424000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2005 | ||||||||
| LastUpdateDate: | 01/13/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PP0204X | MD203408 | LA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Pediatric Emergency Medicine | 208000000X | MD28126 | TN | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 27393 | AL | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | ME 0056444 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 0101053281 | VA | N | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 3810235 | 05 | TN | MEDICAID | 009910809 | 05 | AL | MEDICAID | 515541854 | 01 | AL | BCBS - 1504 SPRINGHILL | OTHER | 04029336 | 05 | MS | MEDICAID | 1807711 | 05 | LA | MEDICAID |