Provider Demographics
NPI:1124069190
Name:LACOUR, JEAN V (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:V
Last Name:LACOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E LIVINGSTON PL
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3941
Mailing Address - Country:US
Mailing Address - Phone:504-837-7854
Mailing Address - Fax:
Practice Address - Street 1:233 E LIVINGSTON PL
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-3941
Practice Address - Country:US
Practice Address - Phone:504-837-7854
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014760207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1336424Medicaid
LAB64938Medicare UPIN
LA1336424Medicaid