Jacob Edward Landry (NPI# 1235495813, PAC ID# 9234361064) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1235495813 |
| PAC ID by PECOS | 9234361064 |
| Professional Enrollment ID | I20170629000006 |
| Full Name | Jacob Edward Landry |
| Organization Legal Name | SOUTHERN UROLOGY, LLC |
| Address |
120 Rue Louis Xiv Lafayette LA 70508-5739 |
| Phone Number | 3377697779 |
| Gender | M |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT |
| Graduation Year | 2012 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 5597833772 |
| Number of Group Practice Members | 25 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190102 | OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC |
| 190255 | PARK PLACE SURGICAL HOSPITAL |
| 190002 | LAFAYETTE GENERAL MEDICAL CENTER |
| 190064 | OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER |
| 190044 | ACADIA GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 120 Rue Louis Xiv, Lafayette, LA 70508-5739 | 3377697779 | SOUTHERN UROLOGY, LLC |
| Organization Legal Name | SOUTHERN UROLOGY, LLC |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura Gamble Owens | Urology | Southern Urology, LLC | 1926 S Union St, Opelousas, LA 70570-5725 |
| Scott Neusetzer | Urology | Southern Urology, LLC | 1016 Coolidge Blvd, Lafayette, LA 70503-2436 |
| Marcel Lahaye | Urology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Frank R Bacque | Urology | Southern Urology, LLC | 602 Saint Landry St, Lafayette, LA 70506-4628 |
| Samuel H Shuffler | Urology | Southern Urology, LLC | 1000 W Pinhook Rd, Suite 304, Lafayette, LA 70503-2460 |
| Jason Bourque | Urology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| William B Roth | Urology | Southern Urology, LLC | 1000 W Pinhook Rd, Suite 304, Lafayette, LA 70503-2460 |
| David A Jones | Radiation Oncology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Jeffrey J Thibodeaux | Urology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Jeannette Chassaignac | Urology | Southern Urology, LLC | 1016 Coolidge Blvd, Lafayette, LA 70503-2436 |
| Street Address |
120 RUE LOUIS XIV |
| City | LAFAYETTE |
| State | LA |
| Zip | 70508-5739 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marcel Lahaye | Urology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Jason Bourque | Urology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| David A Jones | Radiation Oncology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Jeffrey J Thibodeaux | Urology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Donna W Kasper | Nurse Practitioner | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Jason Shumadine | Radiation Oncology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Jason Breaux | General Surgery | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Christopher Paul Fontenot | Urology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| John P Vallee | Urology | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Jill Hill | Nurse Practitioner | Southern Urology, LLC | 120 Rue Louis Xiv, Lafayette, LA 70508-5739 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jason W Prevost | Chiropractic | 2111 W Pinhook Rd A, Integrated Health, Lafayette, LA 70508-1504 | |
| Kimberly V Hull | Nurse Practitioner | Lhc Physician Services, LLC | 901 Hugh Wallis Rd S, Lafayette, LA 70508-2511 |
| Roseanna Laporte | Nurse Practitioner | Lhc Physician Services, LLC | 901 Hugh Wallis Rd S, Lafayette, LA 70508-2511 |
| Mia H Rabalais | Nurse Practitioner | Lhc Physician Services, LLC | 901 Hugh Wallis Rd S, Lafayette, LA 70508-2511 |
| Simone L Babineaux | Nurse Practitioner | Lhc Physician Services, LLC | 901 Hugh Wallis Rd S, Lafayette, LA 70508-2511 |
| Jayson A Thornhill | Nurse Practitioner | Lhc Physician Services, LLC | 901 Hugh Wallis Rd S, Lafayette, LA 70508-2511 |
| Casey A Robinson | Clinical Social Worker | 200 La Rue France, Suite 101, Lafayette, LA 70508-3104 | |
| Rachel Lacy Broussard | Clinical Social Worker | 200 La Rue France, Lafayette, LA 70508-3104 | |
| Joshua G Bailey | Chiropractic | Pinhook Chiropractic Clinic LLC | 100 La Rue France, Lafayette, LA 70508-3112 |
| Brad A Grizzaffi | Chiropractic | Pinhook Chiropractic Clinic LLC | 100 La Rue France, Lafayette, LA 70508-3112 |
| Find all physicians in zip 70508 | |||
| City | LAFAYETTE |
| Zip Code | 70508 |
| Specialty | GENERAL SURGERY |
| City + Specialty | LAFAYETTE + GENERAL SURGERY |
Please comment or provide details below to improve the information on Jacob Edward Landry.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.