Individual
EDWARD JACKSON DEASE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
229 SAINT JOHN LN, COVINGTON, LA 70433
(866) 875-9225
Mailing address
229 SAINT JOHN LN, COVINGTON, LA 70433-3276
(866) 875-9225
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
09339R
LA
207P00000X
Emergency Medicine Physician
00025600
AL
Other
Enumeration date
06/14/2006
Last updated
07/26/2019
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