Russell, Jeremy Lawrence
Russell, Jeremy Lawrence is an individual health care provider with primary practice located at 15790 Paul Vega Md Dr , Hammond LA 70403-1436. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Russell, Jeremy Lawrence can be contacted via phone (985) 345-2700.Contact Information
Primary practice address
15790 Paul Vega Md Dr
Hammond LA 70403-1436
Phone: (985) 345-2700
Fax: (985) 230-6653
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1196694 | Louisiana |
Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 332993 | Louisiana |
Profile Details
NPI number | 1639808306 |
---|---|
LBN Legal business name | Russell, Jeremy Lawrence |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 8th, 2022 |
Last updated | Jun 8th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1639808306 | NPPES |
Louisiana | Other | 1639808306 | NPI |
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