Provider Demographics
NPI:1073518510
Name:LEBAS, STUART JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:JOHN
Last Name:LEBAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOMANS WAY STE 513
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-5100
Mailing Address - Country:US
Mailing Address - Phone:225-924-8550
Mailing Address - Fax:225-924-8647
Practice Address - Street 1:500 RUE DE LA VIE ST STE 513
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-5129
Practice Address - Country:US
Practice Address - Phone:225-924-8550
Practice Address - Fax:225-924-8647
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021347207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1680087Medicaid
TX205835601Medicaid
MS00118007Medicaid
LA5W678N627Medicare PIN
LA1680087Medicaid
LA5W678C022Medicare ID - Type Unspecified
MS00118007Medicaid