Individual
CONSTANCE COLE BLUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4950 ESSEN LN STE 500, BATON ROUGE, LA 70809-3738
(225) 757-0343
(225) 757-8354
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5727
(225) 765-4278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10043536
TX
207RX0202X
Medical Oncology Physician
Primary
207962
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046887
CDS
LA
01
—
207962
STATE LICENSE
LA
01
—
2388266
MEDICAID
LA
Enumeration date
04/23/2012
Last updated
03/07/2023
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