Healthcare Provider Details
I. General information
NPI: 1942399357
Provider Name (Legal Business Name): LLOYD JOSEPH DUPLANTIS JR. P.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/12/2006
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3696 W MAIN ST
GRAY LA
70359-6122
US
IV. Provider business mailing address
3696 W MAIN ST
GRAY LA
70359-6122
US
V. Phone/Fax
- Phone: 985-872-4547
- Fax: 985-580-0213
- Phone: 985-872-4547
- Fax: 985-580-0213
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 9535 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: