Individual
CHAD LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1034 NORTH 500 WEST, PROVO, UT 84604
(801) 373-7850
Mailing address
PO BOX 10, SPANISH FORK, UT 84660-0010
(866) 898-7136
(616) 975-9824
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
58708721204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588604532
—
UT
01
—
58708721200001
BCBS
—
01
—
58708721202001
BCBS
UT
01
—
P00295439
RAILROAD MEDICARE
—
01
—
P00420439
RAIL ROAD MEDICARE
UT
Enumeration date
06/07/2006
Last updated
05/20/2008
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