Individual
BLAINE EDWARD LAVERGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
510 COTTONWOOD ST, BUNKIE, LA 71322
(318) 346-3338
Mailing address
PO BOX 380, BUNKIE, LA 71322-0380
(318) 346-6681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.021983
LA
Other
Enumeration date
07/09/2006
Last updated
07/08/2007
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