Provider Demographics
NPI:1104015361
Name:BELLARD, AURDIE KENT (PD)
Entity Type:Individual
Prefix:MR
First Name:AURDIE
Middle Name:KENT
Last Name:BELLARD
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-5349
Mailing Address - Country:US
Mailing Address - Phone:337-546-6386
Mailing Address - Fax:337-546-1160
Practice Address - Street 1:621 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-5349
Practice Address - Country:US
Practice Address - Phone:337-546-6386
Practice Address - Fax:337-546-1160
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist