Individual
JEREMY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
427 HEYMANN BLVD, LAFAYETTE, LA 70503-2616
(337) 234-1111
Mailing address
427 HEYMANN BLVD, LAFAYETTE, LA 70503-2616
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
300725
LA
Other
Enumeration date
03/18/2019
Last updated
07/13/2022
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