Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 021347 | LA |
N | 207RP1001X | Pulmonary Disease | 021347 | LA |
NPI | 1073518510 |
---|---|
Provider Name | Dr. Stuart John Lebas |
First Address | Baton Rouge, LA 70817-5100 |
Second Address | Baton Rouge, LA 70817-5129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 19/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00118007 | (05) | MS |
1680087 | (05) | LA |
205835601 | (05) | TX |
G23085 | (02) | LA |