Healthcare Provider Details

I. General information

NPI: 1639103567
Provider Name (Legal Business Name): DAVID J REES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 DULLES DR SUITE 1
LAFAYETTE LA
70506-3008
US

IV. Provider business mailing address

302 DULLES DR SUITE 1
LAFAYETTE LA
70506-3008
US

V. Phone/Fax

Practice location:
  • Phone: 337-262-5870
  • Fax: 337-262-1272
Mailing address:
  • Phone: 337-262-5870
  • Fax: 337-262-2172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number8978
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberAR3394931
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number19599
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: