Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 203313 | LA |
N | 2081S0010X | Sports Medicine | 203313 | LA |
N | 213ES0000X | Sports Medicine | 203313 | LA |
NPI | 1144410796 |
---|---|
Provider Name | Dr. Lisa M Jaubert |
First Address | Covington, LA 70433-9169 |
Second Address | Covington, LA 70433-9169 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 21/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1000761 | (05) | LA |