Individual
DR. KENNETH MCIVER BLUE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8080 BLUEBONNET BLVD, STE 3000, BATON ROUGE, LA 70810-7827
(225) 766-8100
(225) 766-3240
Mailing address
8080 BLUEBONNET BLVD, STE 3000, BATON ROUGE, LA 70810-7827
(225) 766-8100
(225) 766-3240
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
011230
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011230
MEDICAL LICENSE
LA
05
—
1117609
—
LA
Enumeration date
06/17/2006
Last updated
08/23/2011
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