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NPI Code Detail

MEDICARE: DR. HERBERT W LEBOURGEOIS III M.D.

MEDICARE:  DR. HERBERT W LEBOURGEOIS III 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
12084P0800XPsychiatry Physician025396LA

Other Identifiers

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

General Provider Information

NPI Number : 1609930346
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HERBERT W LEBOURGEOIS III M.D.
Provider Business Mailing Address
First Line : 5261 HIGHLAND RD # 341
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-6547
Country : US
Telephone Number :
Fax Number : 888-817-3026
Provider Business Practice Location Address
First Line : 2751 WOODDALE BLVD STE A
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-7567
Country : US
Telephone Number : 225-925-1906
Fax Number : 888-817-3026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 10/11/2020

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