Provider Demographics
NPI:1639611668
Name:HEBERT, JOHN (LAC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:HEBERT
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-6102
Mailing Address - Country:US
Mailing Address - Phone:337-593-9796
Mailing Address - Fax:337-593-9796
Practice Address - Street 1:708 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6102
Practice Address - Country:US
Practice Address - Phone:337-593-9796
Practice Address - Fax:337-593-9796
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAACA.C20012171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist