| Jason A Landry A Professional Medical Corporation | |
|
101 La Rue France Suite 303 Lafayette LA 70508-3144 | |
| (337) 706-7966 | |
| (337) 706-7988 |
| Full Name | Jason A Landry A Professional Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 101 La Rue France, Lafayette, Louisiana |
| Authorized Official Name and Position | Jason A Landry (OWNER) |
| Authorized Official Contact | 3377067966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason A Landry A Professional Medical Corporation 101 La Rue France Suite 303 Lafayette LA 70508-3144 Ph: (337) 706-7966 | Jason A Landry A Professional Medical Corporation 101 La Rue France Suite 303 Lafayette LA 70508-3144 Ph: (337) 706-7966 |
| NPI Number | 1972822070 |
|---|---|
| Provider Enumeration Date | 05/28/2010 |
| Last Update Date | 10/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972822070 | NPI | - | NPPES |
| 1893277 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 201584 (Louisiana) | Primary |
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