Provider Demographics
NPI:1699758433
Name:BOURGEOIS, LIONEL P (MD)
Entity type:Individual
Prefix:DR
First Name:LIONEL
Middle Name:P
Last Name:BOURGEOIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2845 MANHATTAN BLVD
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2987
Mailing Address - Country:US
Mailing Address - Phone:504-349-6930
Mailing Address - Fax:504-361-5496
Practice Address - Street 1:2845 MANHATTAN BLVD
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2987
Practice Address - Country:US
Practice Address - Phone:504-349-6930
Practice Address - Fax:504-361-5496
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
LA015631207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA011659OtherCDS
LAAB1244122OtherFEDERAL DEA