Provider Demographics
NPI:1609876473
Name:LEBLANC, BRIAN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:LEBLANC
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-526-0011
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:310 DUREL DR
Practice Address - Street 2:
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760-2973
Practice Address - Country:US
Practice Address - Phone:225-713-2400
Practice Address - Fax:225-713-2405
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2021-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA022125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA080124031OtherRAILROAD MEDICARE
LA1665266Medicaid
LAG10001Medicare UPIN
LA080124031OtherRAILROAD MEDICARE