Provider Demographics
NPI:1932498185
Name:LEON, ILSA (MD)
Entity Type:Individual
Prefix:
First Name:ILSA
Middle Name:
Last Name:LEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:515 WESTBANK EXPY
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-5644
Mailing Address - Country:US
Mailing Address - Phone:504-366-7233
Mailing Address - Fax:504-366-0686
Practice Address - Street 1:515 WESTBANK EXPY
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-5644
Practice Address - Country:US
Practice Address - Phone:504-366-7233
Practice Address - Fax:504-366-0686
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA207961207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology