Individual
JEANNIE Y. JO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
1014 SAINT CLAIR BLVD STE 3015, GONZALES, LA 70737-5030
(225) 745-5500
(225) 743-2459
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5727
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
DPMPD326R
LA
213E00000X
Podiatrist
E4654
CA
213E00000X
Podiatrist
Primary
PD326R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06774745
—
MS
05
—
1714992
—
LA
Enumeration date
06/04/2006
Last updated
03/26/2021
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