Provider Demographics
NPI:1063485811
Name:TORRENCE, LEAMON GARRETT (MD)
Entity type:Individual
Prefix:
First Name:LEAMON
Middle Name:GARRETT
Last Name:TORRENCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 11TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SPRINGHILL
Mailing Address - State:LA
Mailing Address - Zip Code:71075-4503
Mailing Address - Country:US
Mailing Address - Phone:318-539-1700
Mailing Address - Fax:318-539-5688
Practice Address - Street 1:401 11TH ST NE
Practice Address - Street 2:
Practice Address - City:SPRINGHILL
Practice Address - State:LA
Practice Address - Zip Code:71075-4503
Practice Address - Country:US
Practice Address - Phone:318-539-1700
Practice Address - Fax:318-539-5688
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17882207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
95096OtherAR BLUE CROSS
LA1349402Medicaid
15711OtherLA CDS
AT3143144OtherDEA
B63513Medicare UPIN
LA1349402Medicaid