Individual
DR. LEONARD JB BOURGEOIS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1409 CHURCH ST, JEANERETTE, LA 70544-4407
(337) 276-6018
(337) 276-9507
Mailing address
PO BOX 910, JEANERETTE, LA 70544-0910
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
017806
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1365831
—
LA
Enumeration date
09/04/2006
Last updated
07/08/2007
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