JON V. SCHELLACK, M.D. (A PROFESSIONAL MEDICAL CORPORATION) (NPI# 1174624712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174624712 |
| Entity Type | Organization |
| Organization Name | JON V. SCHELLACK, M.D. (A PROFESSIONAL MEDICAL CORPORATION) |
| Other Organization Name | VASCULAR CLINIC |
| Practice Address |
5425 Brittany Dr # B Baton Rouge LA 70808-9144 |
| Practice Telephone | 2257675479 |
| Practice Fax Number | 2257675147 |
| Mailing Telephone | 2257675479 |
| Mailing Fax Number | 2257675147 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JON V SCHELLACK (PRESIDENT) |
| Authorized Official Telephone | 2257675479 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1446564 | 05 |
| Other Name | Type Code |
|---|---|
| Vascular Clinic | Doing Business As Name - Organization |
| Street Address |
5425 BRITTANY DR # B |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70808-9144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790313161 | Leah Michelle Dlugolecki | Student in an Organized Health Care Education/Training Program | Lsu Psychiatry Residency Program, 5246 Brittany Drive, Baton Rouge, LA 70808 | 2020-03-31 |
| 1003376302 | Kristina Pham | Student in an Organized Health Care Education/Training Program | 5246 Brittany Drive, 3rd Floor, Baton Rouge, LA 70808 | 2019-03-22 |
| 1083174486 | John Jay Hogan | Student in an Organized Health Care Education/Training Program | Lsu Emergency Medicine Residency Program, 5246 Brittany Drive, Baton Rouge, LA 70808 | 2019-03-21 |
| 1033682075 | Joseph Bertell Davis Jr. | Case Manager/Care Coordinator | 2460 College Drive, Baton Rouge, LA 70808 | 2019-01-02 |
| 1508340886 | Jennifer Miatech | Student in an Organized Health Care Education/Training Program | 8585 Picardy Ave., Medical Tower 2, Baton Rouge, LA 70808 | 2018-09-21 |
| 1700389137 | Jenee Robins | Case Manager/Care Coordinator | 2100 College Dr Apt 159, Baton Rouge, LA 70808 | 2018-03-12 |
| 1952812893 | Da Vonna Dents | Behavioral Analyst | 418 Stoney Creek Ave, Baton Rouge, LA 70808 | 2017-10-18 |
| 1962925669 | Katharine Elizabeth Blum | Counselor | 7936 Wrenwood Blvd. Ste A, Baton Rouge, LA 70808 | 2017-07-25 |
| 1801316120 | Amie Jackson | Social Worker | 5420 Corporate Blvd. Ste 308, Baton Rouge, LA 70808 | 2017-06-27 |
| 1235660713 | Melissa A Eddy-shelby | Student in an Organized Health Care Education/Training Program | 5000 Hennessy Blvs, Suite 6004, Baton Rouge, LA 70808 | 2017-03-25 |
| Find all providers in zip 70808 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821330093 | Laurel Hadley Hastings | Surgery | 7777 Hennessy Blvd Ste 1008, Baton Rouge, LA 70808 | 2013-03-26 |
| 1730410408 | Vascular Specialty Center LLC | Surgery | 8888 Summa Ave Fl 3, Baton Rouge, LA 70809-3720 | 2010-01-20 |
| 1003926981 | John Douglas Frusha | Surgery | 8595 Picandy Avenue, Suite 320, Baton Rouge, LA 70809-3675 | 2006-08-30 |
| 1518962653 | James E. Craven Iv | Surgery | 7777 Hennessy Blvd Ste 7000, Baton Rouge, LA 70808 | 2005-06-16 |
| 1003321829 | Vascular and Endovascular Specialists, LLC | Surgery | 5211 Essen Ln Ste 5, Baton Rouge, LA 70809-3564 | 2017-12-04 |
| 1932525094 | Vascular Specialty Center LLC | Surgery | 8888 Summa Ave, 3rd Floor, Baton Rouge, LA 70809-3720 | 2014-03-13 |
| 1801112503 | Marvin V Weaver Iv | Surgery | 8888 Summa Ave, Cardiology Tower 3rd Floor, Baton Rouge, LA 70809-3720 | 2010-04-20 |
| 1043453335 | Victor Q Tran | Surgery | 8888 Summa Ave, Cardiology Tower 3rd Floor, Baton Rouge, LA 70809-3720 | 2009-04-15 |
| 1093974099 | Taylor Scott Gwin | Surgery | 8585 Picardy Ave, Suite 310, Baton Rouge, LA 70809-3679 | 2008-06-04 |
| 1326238171 | Gregory D Crenshaw | Surgery | 8888 Summa Ave, Cardiology Tower, 3rd Fl, Baton Rouge, LA 70809-3720 | 2007-07-27 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70808 |
Please comment or provide details below to improve the information on JON V. SCHELLACK, M.D. (A PROFESSIONAL MEDICAL CORPORATION).
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.