Individual
DR. BLAKE LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1615 WOLF CIRCLE, LAKE CHARLES, LA 70605
(337) 433-8400
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8258
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD.204906
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2103245
—
LA
Enumeration date
05/03/2010
Last updated
02/03/2017
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