Provider Demographics
NPI:1619952918
Name:LANCIERS, SOPHIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIE
Middle Name:
Last Name:LANCIERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 BEAU LAC LN
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1456
Mailing Address - Country:US
Mailing Address - Phone:601-427-9266
Mailing Address - Fax:
Practice Address - Street 1:4809 BEAU LAC LN
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1456
Practice Address - Country:US
Practice Address - Phone:601-427-9266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA301880207RB0002X, 2080P0206X
FLME147006208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
No2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01478721Medicaid
LA2431803Medicaid
AZ697154Medicaid
AZH72286Medicare UPIN
MS372841YS8TMedicare PIN