| Doctor Name: | MR. JAMES KEVIN MODISETTE |
| NPI Number: | 1063413995 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 22699 |
| Business Practice Address: | 604 N. Acadia Rd. Suite 405 Thibodaux, LA - 70301 |
| Business Phone Number: | 9854460871 |
| Business Fax Number: | 9854460874 |
| Mailing Address: | 604 N. Acadia Rd., Suite 405 THIBODAUX |
| State: | LA |
| Postal Code: | 70301 |
| Phone Number: | 9854460871 |
| Fax Number: | 9854460874 |
| NPI Enumeration Date: | 08/02/2005 |
| NPI Last Update Date: | 09/25/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RN0300X |
| License Number: | 22699 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Nephrology |
| Taxonomy Definition: | An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |