Healthcare Provider Details

I. General information

NPI: 1396714200
Provider Name (Legal Business Name): MARIA M DOUCET M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA M DOUCET M.D.

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4630 AMBASSADOR CAFFERY PKWY SUITE 402
LAFAYETTE LA
70508-6949
US

IV. Provider business mailing address

604 N ACADIA RD STE 101
THIBODAUX LA
70301-4897
US

V. Phone/Fax

Practice location:
  • Phone: 337-989-4453
  • Fax: 337-988-9287
Mailing address:
  • Phone: 985-446-5079
  • Fax: 985-447-2497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number11438R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: