JEREMY LAWRENCE RUSSELL

HAMMOND, LA
NPI1639808306
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: LA  332993)
Additional Taxonomies363A00000X Physician Assistant
(Licence: LA  1196694)
Enumeration Date2022-06-08
Last Update Date2023-06-08
Business Address
Mr. JEREMY LAWRENCE RUSSELL PA-C
15790 PAUL VEGA MD DR
HAMMOND, LA 70403-1436
Phone number: 985-345-2700
Mailing Address
Mr. JEREMY LAWRENCE RUSSELL PA-C
PO BOX 1389
ALBANY, LA 70711-1389
Phone number: 985-320-2195
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