Provider Demographics
NPI:1629050398
Name:LAFLEUR, EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:LAFLEUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 E MILTON AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5346
Mailing Address - Country:US
Mailing Address - Phone:337-470-3260
Mailing Address - Fax:337-856-6388
Practice Address - Street 1:2445 E MILTON AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5346
Practice Address - Country:US
Practice Address - Phone:337-470-3260
Practice Address - Fax:337-856-6388
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025580207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1042765Medicaid
LA5CK60Medicare ID - Type Unspecified
LA1042765Medicaid