Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 7092 | LA |
Y | 213EG0000X | General Practice | 7092 | LA |
NPI | 1003432253 |
---|---|
Provider Name | Christopher Peter Blanchard |
First Address | Hammond, LA 70403-2172 |
Second Address | Hammond, LA 70403-6125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2020 |
Last Update Date | 21/01/2021 |