Individual
JEFFREY LACOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15813 PAUL VEGA MD DR, SUITE 301, HAMMOND, LA 70403-1495
(985) 230-2630
(985) 230-2634
Mailing address
PO BOX 2668, HAMMOND, LA 70404-2668
(985) 230-2630
(985) 230-2634
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
026458
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063673
—
LA
Enumeration date
04/26/2007
Last updated
11/21/2011
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