Individual
JACOB KYLE LEBAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 6003, BATON ROUGE, LA 70808-4300
(225) 765-5927
Mailing address
2335 CHURCH ST STE E, ZACHARY, LA 70791-2700
(225) 570-2489
(225) 570-2986
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.207620
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2199978
—
LA
Enumeration date
07/20/2012
Last updated
01/26/2020
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