Individual
JEFFREY JOHN DAIGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1615 WOLF CIR, LAKE CHARLES, LA 70605-2348
(337) 312-8681
(337) 312-8682
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8258
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200462
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2161113
—
LA
Enumeration date
07/07/2011
Last updated
12/27/2019
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