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General NPI Number Information
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NPI Number | 1528342045
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Entity Type | Organization
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Legal Business Name | JONATHAN B PURDY DPM APMC
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 200 S LEWIS ST
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City | NEW IBERIA
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State | LA
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Zip | 70560-3916
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Country | US
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Telephone | 337-256-8494
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Fax | 855-896-3338
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Provider Business Mailing Address
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Address Line | 200 S LEWIS ST
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City | NEW IBERIA
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State | LA
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Zip | 70560-3916
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Country | US
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Telephone | 337-256-8494
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Fax | 855-896-3338
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN B PURDY
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Credential | DPM
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Telephone | 337-256-8494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DPM.PD323R
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License Number State | LA
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