Individual
MR. KANCHAN PRASAD UPADHYAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
931 VERONE TER, LEESVILLE, LA 71446-4255
(337) 238-3475
(337) 238-3617
Mailing address
1000 N 5TH ST, LEESVILLE, LA 71446-2901
(337) 238-3475
(337) 238-3617
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
13173R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578924
—
LA
01
—
260053101
TRICARE
LA
01
—
36-00370
UNITED HEALTH CARE
LA
Enumeration date
07/06/2006
Last updated
03/10/2020
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