MEDICARE: DR. CHARLES A LEBLANC M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	015701	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548255722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES A LEBLANC M.D.

Provider Business Mailing Address
First Line	:	604 N ACADIA RD STE 101
Second Line	:
City	:	THIBODAUX
State	:	LA
Zip	:	70301-4897
Country	:	US
Telephone Number	:	985-446-5079
Fax Number	:	985-447-2497

Provider Business Practice Location Address
First Line	:	5258 DIJON DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4311
Country	:	US
Telephone Number	:	225-769-1090
Fax Number	:	225-769-4812

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	03/05/2024

Similar Medicare Providers

1033096706 — TREY PARKER
Practice Location Address:

5228 DIJON DR
BATON ROUGE, LA
70808-4311

Practice Phone: 225-765-8829
Practice Fax: 225-765-6916

1629075999 — DR. DANIEL E MARSH MD
Practice Location Address:

5238 DIJON DR
BATON ROUGE, LA
70808-4311

Practice Phone: 225-526-0365
Practice Fax: 225-526-0365

1083614721 — DR. CHARLES RAY HALLIBURTON JR. M.D.
Practice Location Address:

5228 DIJON DR
BATON ROUGE, LA
70808-4311

Practice Phone: 225-765-8829
Practice Fax: 225-765-8283

1902891476 — DR. RYAN T BOONE M.D.
Practice Location Address:

5258 DIJON DR
BATON ROUGE, LA
70808-4311

Practice Phone: 225-769-1090
Practice Fax: 225-769-4812

1609861871 — DR. CHARLES F MITCHELL II M.D.
Practice Location Address:

5258 DIJON DR
BATON ROUGE, LA
70808-4311

Practice Phone: 225-769-1090
Practice Fax: 225-769-4812

1225028038 — ENT MEDICAL CENTER
Practice Location Address:

5258 DIJON DR
BATON ROUGE, LA
70808-4311

Practice Phone: 225-769-1090
Practice Fax: 225-769-4812

Directions to “ DR. CHARLES A LEBLANC M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.