Individual
JEFFREY PAUL LASSIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
295 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 495-6200
(952) 883-9677
Mailing address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-2000
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
49327
MN
2085R0202X
Diagnostic Radiology Physician
49327
MN
2085R0204X
Vascular & Interventional Radiology Physician
49327
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558459032
—
MN
Enumeration date
10/10/2006
Last updated
01/17/2025
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