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
—
—
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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