Provider Demographics
NPI:1699749929
Name:LAFLEUR, KENNETH C (MD)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:C
Last Name:LAFLEUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1090
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70571-1090
Mailing Address - Country:US
Mailing Address - Phone:337-942-3613
Mailing Address - Fax:337-948-8379
Practice Address - Street 1:1110 DR AC TERRANCE BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6403
Practice Address - Country:US
Practice Address - Phone:337-342-3613
Practice Address - Fax:337-948-8379
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2007-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA010466207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1119946Medicaid
LAP00072902Medicare PIN
LA1119946Medicaid
LAB64952Medicare UPIN
LA53930Medicare PIN