Individual
DR. JASON D. LANDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
121 RUE LOUIS XIV, BUILDING 9, SUITE A, LAFAYETTE, LA 70508
(337) 988-9737
(337) 988-9739
Mailing address
121 RUE LOUIS XIV, BUILDING 9, SUITE A, LAFAYETTE, LA 70508
(337) 988-9737
(337) 988-9739
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
201261
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1238376
—
LA
01
—
P00808639
RR MEDICARE
LA
Enumeration date
05/18/2007
Last updated
02/03/2020
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