Healthcare Provider Details

I. General information

NPI: 1275065633
Provider Name (Legal Business Name): CALEB DUPRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8166 MAIN ST
HOUMA LA
70360-3404
US

IV. Provider business mailing address

8166 MAIN ST
HOUMA LA
70360-3404
US

V. Phone/Fax

Practice location:
  • Phone: 985-873-3689
  • Fax: 985-873-3109
Mailing address:
  • Phone: 985-873-3689
  • Fax: 985-873-3109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number312070
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number312070
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number312070
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: