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Individual

KIM EDWARD LEBLANC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
2820 NAPOLEON AVE, SUITE 890, NEW ORLEANS, LA 70115-6969
(504) 412-1366
(504) 412-1367
Mailing address
1340 POYDRAS ST, SUITE 1640, NEW ORLEANS, LA 70112-1221
(504) 412-1835

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
014590
LA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
014590
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1309532
LA
Enumeration date
07/25/2006
Last updated
10/29/2008
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