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NPI Code Detail

MEDICARE: JASPER EMERGENCY MEDICINE ASSOCIATES PA

MEDICARE: JASPER EMERGENCY MEDICINE ASSOCIATES PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant
2363L00000XNurse Practitioner
3207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1346442746
Entity Type Code : Organization
Provider Name (Legal Business Name) : JASPER EMERGENCY MEDICINE ASSOCIATES PA
Provider Business Mailing Address
First Line : 200 CORPORATE BLVD
Second Line : SUITE 201
City : LAFAYETTE
State : LA
Zip : 70508-3870
Country : US
Telephone Number : 800-893-9698
Fax Number :
Provider Business Practice Location Address
First Line : 1275 MARVIN HANCOCK DR
Second Line :
City : JASPER
State : TX
Zip : 75951-4935
Country : US
Telephone Number : 409-384-5461
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. MICHAEL A PAWLOWSKI
Credential : MD
Telephone Number : 800-893-9698
Provider Enumeration Date : 06/05/2007
Last Update Date : 02/28/2008

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Directions to “JASPER EMERGENCY MEDICINE ASSOCIATES PA ” Practice Location

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