Provider Demographics
NPI:1720352388
Name:WENDY V. JAMISON, MD, APMC
Entity Type:Organization
Organization Name:WENDY V. JAMISON, MD, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:V
Authorized Official - Last Name:JAMISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-780-9112
Mailing Address - Street 1:4224 HOUMA BLVD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2933
Mailing Address - Country:US
Mailing Address - Phone:504-780-9112
Mailing Address - Fax:504-888-1715
Practice Address - Street 1:4224 HOUMA BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2933
Practice Address - Country:US
Practice Address - Phone:504-780-9112
Practice Address - Fax:504-888-1715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1358134Medicaid
LAB61968Medicare UPIN
LA1235138645Medicare NSC