Provider Demographics
NPI:1881821668
Name:RUDD, JASON (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:RUDD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1200 PINNACLE PKWY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-9167
Mailing Address - Country:US
Mailing Address - Phone:985-674-1700
Mailing Address - Fax:985-674-1722
Practice Address - Street 1:1200 PINNACLE PKWY
Practice Address - Street 2:SUITE 3
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-9167
Practice Address - Country:US
Practice Address - Phone:985-674-1700
Practice Address - Fax:985-674-1722
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2021-06-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.204827207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery