Individual
JOHN LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
194 E MAIN ST, FORT KENT, ME 04743-1428
(207) 834-1329
(207) 834-2949
Mailing address
194 E MAIN ST, FORT KENT, ME 04743-1428
(207) 834-3155
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
DO3066
ME
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
DO3066
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750367066
—
ME
01
—
DO3066
STATE LICENSE
ME
Enumeration date
12/19/2005
Last updated
08/13/2020
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