Provider Demographics
NPI:1891093746
Name:LEBLANC, KAREN MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 S CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PITTSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37380-1303
Mailing Address - Country:US
Mailing Address - Phone:423-837-8611
Mailing Address - Fax:423-837-8612
Practice Address - Street 1:233 S CEDAR AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PITTSBURG
Practice Address - State:TN
Practice Address - Zip Code:37380-1303
Practice Address - Country:US
Practice Address - Phone:423-837-8611
Practice Address - Fax:423-837-8612
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002965152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist