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Edward Jackson Dease III, M.D.

Anesthesiology in Covington, LA. Individual provider (NPI-1).

NPI number1881637973
StatusActive
Last updated in NPPESJul 26, 2019

Details

NPI
1881637973
Entity type
Individual (NPI-1)
Name
Edward Jackson Dease III
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 14, 2006
Last updated
Jul 26, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207L00000X Anesthesiology09339RLAYes
207P00000X Emergency Medicine00025600AL

Practice location

229 Saint John Ln
Covington, LA 70433

Phone 866-875-9225

Mailing address

229 Saint John Ln
Covington, LA 70433-3276

Phone 866-875-9225

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