Provider Demographics
NPI:1083072391
Name:LEBLANC, JOSEPH GARY JR (PHARMD, MHA, MBA)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GARY
Last Name:LEBLANC
Suffix:JR
Gender:M
Credentials:PHARMD, MHA, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 HIGHWAY 28 EAST
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360
Mailing Address - Country:US
Mailing Address - Phone:318-229-4185
Mailing Address - Fax:318-229-4186
Practice Address - Street 1:2750 HIGHWAY 28 E
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5713
Practice Address - Country:US
Practice Address - Phone:318-229-4185
Practice Address - Fax:318-229-4186
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist