Individual
KIMBERLY LANDRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1201 W FERTITTA BLVD, LEESVILLE, LA 71446-4637
(337) 392-9438
(337) 392-9440
Mailing address
1201 W FERTITTA BLVD, LEESVILLE, LA 71446-4637
(337) 392-9438
(337) 392-9440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD207972
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2423380
—
LA
Enumeration date
06/08/2012
Last updated
09/28/2016
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