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Individual

JACOB MICHAEL O'QUIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4801 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6917
(337) 470-2605
(337) 470-4595
Mailing address
1214 COOLIDGE BLVD, LAFAYETTE, LA 70503-2621
(337) 289-7991

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
313223
LA

Other

Enumeration date
04/21/2019
Last updated
02/22/2021
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