Provider Demographics
NPI:1144724378
Name:ST. CYR, LOGAN LEBLANC (MD)
Entity type:Individual
Prefix:MS
First Name:LOGAN
Middle Name:LEBLANC
Last Name:ST. CYR
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 1:5246 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9136
Mailing Address - Country:US
Mailing Address - Phone:225-757-4300
Mailing Address - Fax:
Practice Address - Street 1:8120 MAIN ST STE 304
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-3403
Practice Address - Country:US
Practice Address - Phone:985-873-3484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA325710207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine