Basic Information
| Provider Information | |||||||||
| NPI: | 1902099286 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERRIEN | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4224 HOUMA BLVD STE 500 | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700062938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044550842 | ||||||||
| FaxNumber: | 5045036737 | ||||||||
| Practice Location | |||||||||
| Address1: | 4224 HOUMA BLVD STE 500 | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700062938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044550842 | ||||||||
| FaxNumber: | 5045036737 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2007 | ||||||||
| LastUpdateDate: | 01/24/2019 | ||||||||
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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 | 207R00000X | 2007017167 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | MD.207222 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 2371215 | 05 | LA | MEDICAID |