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Organization
JON V. SCHELLACK, M.D. (A PROFESSIONAL MEDICAL CORPORATION)
Active
Organization
JON V. SCHELLACK, M.D. (A PROFESSIONAL MEDICAL CORPORATION)
Active
Other names
Vascular Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON V SCHELLACK M.D. (PRESIDENT)
(225) 767-5479
Entity
Organization
Contact information
Practice address
5425 BRITTANY DR # B, BATON ROUGE, LA 70808-9144
(225) 767-5479
(225) 767-5147
Mailing address
5425 BRITTANY DR # B, BATON ROUGE, LA 70808-9144
(225) 767-5479
(225) 767-5147
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1446564
—
LA
Enumeration date
09/26/2006
Last updated
08/22/2020
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