Individual
DR. BLAKE MCDONALD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-6000
Mailing address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(985) 637-7876
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
306949
LA
Other
Enumeration date
04/10/2014
Last updated
09/29/2017
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