Provider Demographics
NPI:1114347515
Name:LANDRY, JULIE LAGARDE (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LAGARDE
Last Name:LANDRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANNE
Other - Last Name:LAGARDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 HIGHLAND PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7116
Mailing Address - Country:US
Mailing Address - Phone:985-898-5990
Mailing Address - Fax:
Practice Address - Street 1:106 HIGHLAND PARK PLZ
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7116
Practice Address - Country:US
Practice Address - Phone:985-898-5990
Practice Address - Fax:985-590-3719
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.308514207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology