Provider Demographics
NPI:1447988266
Name:VEAL, JON-PATRIC B
Entity type:Individual
Prefix:
First Name:JON-PATRIC
Middle Name:B
Last Name:VEAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11408 LAKE SHERWOOD AVE N STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-0421
Mailing Address - Country:US
Mailing Address - Phone:252-617-1432
Mailing Address - Fax:225-250-1026
Practice Address - Street 1:11408 LAKE SHERWOOD AVE N STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-0421
Practice Address - Country:US
Practice Address - Phone:252-617-1432
Practice Address - Fax:225-250-1026
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2023-07-19
Deactivation Date:2023-05-21
Deactivation Code:
Reactivation Date:2023-07-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator