Provider Demographics
NPI:1215928163
Name:FALTERMAN, JAMES B JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:FALTERMAN
Suffix:JR
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 1:2313 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-4091
Mailing Address - Country:US
Mailing Address - Phone:337-365-9602
Mailing Address - Fax:337-365-0071
Practice Address - Street 1:2313 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-4091
Practice Address - Country:US
Practice Address - Phone:337-365-9602
Practice Address - Fax:337-365-0071
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA115780174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1367451Medicaid
LA1367451Medicaid
LAB64367Medicare UPIN