Landry, Blake C.
Landry, Blake C. is an sole proprietor health care provider with primary practice located at 2365 Gause Blvd E Ste E , Slidell LA 70461-4142. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Other Service Providers / Specialist. Other Service Providers / Specialist is his primary health care specialty. Landry, Blake C. can be contacted via phone (985) 643-1194.Contact Information
Primary practice address
2365 Gause Blvd E Ste E
Slidell LA 70461-4142
Phone: (985) 643-1194
Fax: (985) 643-8869
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 022661 | Louisiana |
| Other Service Providers / Specialist | 174400000X | 022661 | Louisiana |
Profile Details
| NPI number | 1417953597 |
|---|---|
| LBN Legal business name | Landry, Blake C. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 23rd, 2005 |
| Last updated | Apr 1st, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417953597 | NPPES |
| Louisiana | Other | 720847461 0009 | CIGNA |
| Louisiana | Other | 153236130118 | CIGNA |
| Louisiana | Other | 0005507718 | CIGNA |
| Louisiana | MEDICAID | 1494895 | CIGNA |
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