Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI Number | 1184977555 |
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| LBN Legal business name | LUKE V. DESJARLAIS, PLLC | ||||
| Authorized official | LUKE DESJARLAIS - (CEO) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 10/22/2012 | ||||
| Last updated | 10/22/2012 - About 14 years ago | ||||
| Identifiers |
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