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Individual

JONATHAN B PURDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1100 ANDRE ST, SUITE 202, NEW IBERIA, LA 70563-2159
(337) 256-8494
(337) 256-8945
Mailing address
1100 ANDRE ST, SUITE 202, NEW IBERIA, LA 70563-2159
(337) 256-8494
(337) 256-8945

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PD323R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1464635
LA
01
453278920
TRICARE
01
J5468
BLUE CROSS BLUE SHIELD
LA
Enumeration date
09/14/2005
Last updated
11/28/2012
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