Provider Demographics
NPI:1629104344
Name:BLANCHARD, ANTHONY I (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:I
Last Name:BLANCHARD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:232 SAINT PIERRE BLVD
Mailing Address - Street 2:STE 2
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-3914
Mailing Address - Country:US
Mailing Address - Phone:337-981-4001
Mailing Address - Fax:337-981-5148
Practice Address - Street 1:1555 GARY DR
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-3448
Practice Address - Country:US
Practice Address - Phone:337-806-3349
Practice Address - Fax:337-909-2216
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAPD140R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1972690Medicaid
LA5R834C774Medicare ID - Type Unspecified
LA1972690Medicaid