Healthcare Provider Details

I. General information

NPI: 1619965340
Provider Name (Legal Business Name): SHAUN LAPLEAU MCINTIRE M.D., M.P.H., F.A.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N FOSTER DR
BATON ROUGE LA
70806-1818
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 225-987-9013
  • Fax: 225-987-9093
Mailing address:
  • Phone: 225-987-9013
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.020374
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD.020374
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: