Provider Demographics
NPI:1790826824
Name:HARRY F JASMIN MD LLC
Entity Type:Organization
Organization Name:HARRY F JASMIN MD LLC
Other - Org Name:FIRST HEALTH MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:JASMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-809-5290
Mailing Address - Street 1:2101 N HIGHWAY 190 STE 103
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-8975
Mailing Address - Country:US
Mailing Address - Phone:985-809-5290
Mailing Address - Fax:985-875-1275
Practice Address - Street 1:2101 N HIGHWAY 190 STE 103
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8975
Practice Address - Country:US
Practice Address - Phone:985-809-5290
Practice Address - Fax:985-875-1275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200145174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAI35309Medicare UPIN