Provider Demographics
NPI:1447250311
Name:MONTELARO, JAMES STANDISH (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STANDISH
Last Name:MONTELARO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:604 N ACADIA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4897
Mailing Address - Country:US
Mailing Address - Phone:985-446-5079
Mailing Address - Fax:985-447-2497
Practice Address - Street 1:8080 BLUEBONNET BLVD STE 2222
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-7828
Practice Address - Country:US
Practice Address - Phone:225-769-2222
Practice Address - Fax:225-766-2068
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN1115207Y00000X
LA11251R207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB5084OtherBLUE CROSS
LAG03240Medicare UPIN
LA1660787Medicare ID - Type Unspecified