Individual
DR. JUAN SANTIAGO BLANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1125 MARGUERITE ST, MORGAN CITY, LA 70380-1855
(504) 866-1336
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(504) 866-1336
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
07362R
LA
207R00000X
Internal Medicine Physician
Primary
07362R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1371254
—
LA
Enumeration date
06/07/2006
Last updated
04/11/2018
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