Individual
DR. STEPHEN LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3704 HIGHWAY 39 N, MERIDIAN, MS 39301-1309
(601) 693-0216
(601) 693-6313
Mailing address
1513 LAKELAND DR STE 101, JACKSON, MS 39216-4829
(601) 354-4836
(601) 354-2619
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23514
MS
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
23514
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09975030
—
MS
Enumeration date
06/29/2012
Last updated
04/26/2022
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