Organization Name: | HENRY J DUPRE MD PC |
NPI Number: | 1316295538 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LORETTA FITZPATRICK (CONSULTANT) |
Mailing Address: | 1008 W Main St Ville Platte |
State: | LA US |
Postal Code: | 705864208 |
Phone Number: | 3373635531 |
Fax Number: | |
NPI Enumeration Date: | 08/20/2012 |
NPI Last Update Date: | 04/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | 002493 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |