Provider Demographics
NPI:1093756090
Name:LEBOEUF, RICHARD PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PAUL
Last Name:LEBOEUF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2800 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6130
Mailing Address - Country:US
Mailing Address - Phone:504-309-9364
Mailing Address - Fax:504-309-9375
Practice Address - Street 1:2800 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 340
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6130
Practice Address - Country:US
Practice Address - Phone:504-309-9364
Practice Address - Fax:504-309-9375
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11896208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1144835Medicaid
LAB64983Medicare UPIN