=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982742193
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DEBOISBLANC & CONTREARY, LTD.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4224 HOUMA BLVD SUITE 330
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70006-2933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-454-6338
-----------------------------------------------------
Fax | 504-456-8016
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4224 HOUMA BLVD SUITE 330
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70006-2933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-454-6338
-----------------------------------------------------
Fax | 504-456-8016
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | KELVIN J. CONTREARY
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 504-454-6338
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------