Provider Demographics
NPI:1730234568
Name:MENARD, JAMES LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LYNN
Last Name:MENARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-6201
Mailing Address - Country:US
Mailing Address - Phone:337-334-4100
Mailing Address - Fax:337-334-4177
Practice Address - Street 1:117 E OAK ST
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-6201
Practice Address - Country:US
Practice Address - Phone:337-334-4100
Practice Address - Fax:337-334-4177
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4B847Medicare ID - Type Unspecified