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General NPI Number Information
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NPI Number | 1699273292
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Entity Type | Individual
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Provider Name | LEON LAPLEAU MCINTIRE SR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 910 E 3RD ST
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City | CROWLEY
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State | LA
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Zip | 70526-5308
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Country | US
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Telephone | 706-761-5751
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 173
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City | FORTSON
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State | GA
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Zip | 31808-0173
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Country | US
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Telephone | 706-571-3544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD.008638
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.008638
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License Number State | LA
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