Provider Demographics
NPI:1972713519
Name:LASSEIGNE, KEVIN J JR (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:J
Last Name:LASSEIGNE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:108 RUE LOUIS XIV
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5739
Mailing Address - Country:US
Mailing Address - Phone:337-235-8007
Mailing Address - Fax:855-270-5479
Practice Address - Street 1:108 RUE LOUIS XIV
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5739
Practice Address - Country:US
Practice Address - Phone:337-235-8007
Practice Address - Fax:855-270-5479
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2016-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA203148208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1982834966OtherGROUP NPI