Organization
JENS F GRAVERSEN MD APM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY HARRIS (OFFICE MANAGER)
(985) 542-1226
Entity
Organization
Contact information
Practice address
15770 PAUL VEGA MD DR, STE 200, HAMMOND, LA 70403-1475
(985) 542-1226
(985) 542-2887
Mailing address
15770 PAUL VEGA MD DR, STE 200, HAMMOND, LA 70403-1475
(985) 542-1226
(985) 542-2887
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD200326
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598551
—
LA
Enumeration date
02/11/2008
Last updated
06/04/2008
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