Individual
BLAKE RANDALL LAVESPERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
4315 HOUMA BLVD STE 401, METAIRIE, LA 70006-2941
(504) 702-3000
(504) 889-5451
Mailing address
3921 CLERMONT DR, NEW ORLEANS, LA 70122-4811
(318) 623-0823
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/04/2019
Last updated
03/08/2022
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