Provider Demographics
NPI:1548604986
Name:A. STEPHEN JASE, M.D., APMC
Entity Type:Organization
Organization Name:A. STEPHEN JASE, M.D., APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:JASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-264-2116
Mailing Address - Street 1:PO BOX 19644
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70179-0644
Mailing Address - Country:US
Mailing Address - Phone:504-264-2116
Mailing Address - Fax:504-617-6108
Practice Address - Street 1:11000 N HARDY ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-2838
Practice Address - Country:US
Practice Address - Phone:504-264-2116
Practice Address - Fax:504-617-6108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207R00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty