Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JEREMY LAWRENCE RUSSELL, PA-C
ActiveMR. JEREMY LAWRENCE RUSSELL, PA-C is a Surgical Physician Assistant healthcare provider located in HAMMOND, Louisiana. NPI 1639808306 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · HAMMOND, LA
Registration Details
- NPI Number
- 1639808306
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 8, 2022 (4.2169626094412 yrs)
- Last Updated
- Jun 8, 2023
- Licenses
-
1196694 (LA)332993 (LA)
Practice Information
- Address
-
15790 PAUL VEGA MD DRHAMMOND, LA, 704031436Browse LA providers · Browse ZIP 70403
- Phone
- 9853452700
- Fax
- 9852306653
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Surgical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.