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General NPI Number Information
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NPI Number | 1790826824
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Entity Type | Organization
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Legal Business Name | HARRY F JASMIN MD LLC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2101 N HIGHWAY 190 STE 103
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City | COVINGTON
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State | LA
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Zip | 70433-8975
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Country | US
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Telephone | 985-809-5290
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Fax | 985-875-1275
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Provider Business Mailing Address
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Address Line | 2101 N HIGHWAY 190 STE 103
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City | COVINGTON
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State | LA
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Zip | 70433-8975
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Country | US
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Telephone | 985-809-5290
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Fax | 985-875-1275
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Authorized Official
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Title or Position | OWNER
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Name | DR. HARRY F JASMIN
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Credential | M.D.
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Telephone | 985-809-5290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 200145
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License Number State | LA
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