Provider Demographics
NPI:1720074065
Name:ERNEST J MENCER, MD JEFFREY C. LITTLETON MD APMC
Entity type:Organization
Organization Name:ERNEST J MENCER, MD JEFFREY C. LITTLETON MD APMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MENCER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-769-1300
Mailing Address - Street 1:7777 HENNESSY BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-769-1300
Mailing Address - Fax:225-769-1902
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-769-1300
Practice Address - Fax:225-769-1902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1792250Medicaid
LA1792250Medicaid
LAB89632Medicare UPIN
LA56925Medicare ID - Type Unspecified