Individual
MR. EMILE WILLARD ELLENDER LEGENDRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-6000
Mailing address
205 BEVERLY DR, LAFAYETTE, LA 70503-3107
(337) 534-7040
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
310500
LA
Other
Enumeration date
09/05/2018
Last updated
11/30/2018
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