Provider Demographics
NPI:1871688424
Name:LEBLANC, PAUL DINKEY JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DINKEY
Last Name:LEBLANC
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 RICHELIEU CIRCLE
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560
Mailing Address - Country:US
Mailing Address - Phone:337-365-1272
Mailing Address - Fax:337-365-5613
Practice Address - Street 1:1104 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560
Practice Address - Country:US
Practice Address - Phone:337-365-8048
Practice Address - Fax:337-365-5350
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA9263OtherPHARMACY LICENSE NUMBER