Individual
MR. LEROY JOSEPH RICHARD SR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3305 W PINHOOK RD, LAFAYETTE, LA 70508-3506
(337) 233-4480
(337) 233-6334
Mailing address
134 CRESCENT LN, SUNSET, LA 70584-6115
(337) 662-3063
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A10186LA
LA
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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