Basic Information
| Provider Information | |||||||||
| NPI: | 1497913313 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROLFE | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1444 PETERMAN DR | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713013432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184425399 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3330 MASONIC DR | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 71301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184486970 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2008 | ||||||||
| LastUpdateDate: | 07/18/2018 | ||||||||
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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 | 207L00000X | 122343 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 0101248327 | VA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | MD.207622 | LA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.