Individual
MR. JERRY LYNN SEPULVADO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1525 OAK PARK BLVD, LAKE CHARLES, LA 70601-8849
(337) 494-2023
Mailing address
1525 OAK PARK BLVD, LAKE CHARLES, LA 70601-8849
(337) 494-2023
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
333579
LA
Other
Enumeration date
06/03/2021
Last updated
02/22/2024
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