Individual
LEAH GONSOULIN JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3421 N CAUSEWAY BLVD STE 202, METAIRIE, LA 70002-3759
(504) 832-6612
Mailing address
3421 N CAUSEWAY BLVD STE 202, METAIRIE, LA 70002-3759
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD.205516
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1977161
—
LA
Enumeration date
03/20/2009
Last updated
11/19/2024
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