MEDICARE: LUCIUS J. DOUCET, III, MD, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD.019318	LA

General Provider Information

NPI Number	:	1083899173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUCIUS J. DOUCET, III, MD, LLC

Provider Business Mailing Address
First Line	:	8490 PICARDY AVE
Second Line	:	BLDG 600 B
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3731
Country	:	US
Telephone Number	:	225-810-3911
Fax Number	:	225-810-3954

Provider Business Practice Location Address
First Line	:	8490 PICARDY AVE
Second Line	:	BLDG 600 B
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3731
Country	:	US
Telephone Number	:	225-810-3911
Fax Number	:	225-810-3954

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. MICHELLE R LABORDE
Credential	:
Telephone Number	:	225-810-3911

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	07/26/2012

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