Healthcare Provider Details
I. General information
NPI: 1871476929
Provider Name (Legal Business Name): TSSC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1615 METAIRIE RD STE 101
METAIRIE LA
70005-3982
US
IV. Provider business mailing address
1615 METAIRIE RD STE 101
METAIRIE LA
70005-3982
US
V. Phone/Fax
- Phone: 504-644-4226
- Fax: 504-208-1135
- Phone: 504-644-4226
- Fax: 504-208-1135
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ND0101X |
| Taxonomy | MOHS-Micrographic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KEITH
LEBLANC
JR.
Title or Position: OWNER
Credential: MD
Phone: 504-644-4226