NPI 1013579150

Bradley Lane Jimerson, DPM

Practitioner Foot & Ankle Surgery Podiatrist Lake Charles, LA

Practice location

Address: 1747 Imperial Blvd, Lake Charles, LA 70605-5362
Phone: (337) 721-7236
Fax: (337) 721-7237

Registered specialties (2)

Foot & Ankle Surgery Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence 322786 (LA)

Other Podiatrist providers in Louisiana →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X Licence PO9593 (LA)

Other Student in an Organized Health Care Education/Training Program providers in Louisiana →

Registry record

NPI: 1013579150
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Jun 2019
Record last updated: 1 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.